Key Insights on Upadacitinib’s Efficacy for Non-Segmental Vitiligo, With Thierry Passeron, MD, PhD

New research continues to emerge in the vitiligo treatment landscape, and clinicians in the skin health space are beginning to see meaningful shifts in the previously limited systemic therapy landscape.

In an interview conducted at the 2026 American Academy of Dermatology (AAD) Annual Meeting in Denver, the HCPLive editorial team spoke about some new data on upadacitinib for non-segmental vitiligo alongside Thierry Passeron, MD, PhD, professor and chair of the Department of Dermatology at the Université Côte d'Azur in Nice, France.

The team spoke with Passeron about the latest phase 3 findings on upadacitinib, a Janus-kinase (JAK) inhibitor, resulting from the Viti-Up-1 and Viti-Up-2 studies, as well as the drug’s significance in the broader evolution of vitiligo care.1,2 The following Q&A includes his responses:

HCPLive: Would you tell us a bit about the new data that you presented, putting it into its proper context within the current treatment landscape for vitiligo?

Passeron: We know now that vitiligo is an autoimmune disorder. Unfortunately, so far, there is no systemic treatment approved for vitiligo, and there is still a high need for patients suffering from vitiligo. Here we report the first phase 2 and phase 3 studies on the use of upadacitinib 15 milligrams for adults, but also adolescents, more than 12 years old, suffering from non-segmental vitiligo. There were two studies…They included patients with non-segmental vitiligo affecting both the face and the body. On the face, the inclusion criteria were a F-VASI ≥ 0·5 and a [Total Vitiligo Area Scoring Index (T-VASI)] ≥ 5. It was 48 weeks study and compared to a placebo, and the randomization was 2 to 1, so the patient received either upadacitinib 15 milligrams or the placebo once daily.

HCPLive: Were there any other notable elements of the study design worth mentioning?

Passeron: It was equally men and women. Most of the patients were White, followed by Asian, and not that many Black patients. Most of the patients were skin types 3 and 4. Very importantly, it was a very severe population…Both co-primary endpoints were met and were highly significant against placebo. About 20% of the patients, after 48 weeks, reached T-VASI 50 compared to about 6% in placebo…The results between the 2 studies were quite similar. So it's positive results. What was so important was that we know that in vitiligo, it takes a lot of time. And here it was true monotherapy without phototherapy, without su-exposure.

What we are seeing is that there is increased repigmentation during this time, and it's not reaching a plateau, which is not surprising. We know that we need most of the time, 1, 2, or 3 years to get optimal repigmentation In vitiligo, and even more in patients who are that severe, such as in this study.

The last but very important point is safety. In fact, this is the first study assessing any JAK inhibitors against a placebo for a period of over 48 weeks. The tolerance was very good in the groups in the 2 studies. There was no new safety signal. What we usually expect with JAK inhibitors is some nasopharyngitis, acne, folliculitis, but no MACE, no BTA, no gastrointestinal perforation. So, a very good safety profile in this population, which is very reassuring.

HCPLive: What might be some next steps for this research on upadacitinib in this population?

Passeron: In fact, we are looking forward to the longer-term results, because now the study is continuing in open-label for 2 years. After two years, the patient who wants to can combine with narrow band UVB, and we’re already seeing in my department that the patient is continuing to improve. But we are we must wait for the results, and I'm quite optimistic also that…it will boost the recommendation. But what is already good is that it also halts the disease progression for those patients who are very active, it also halts the disease progression, which is something very important for the patient, not seeing the lesions growing and growing indefinitely.

HCPLive: Were there any differences among subgroups you highlighted in these analyses?

Passeron: We don't know yet. We didn't analyze the subgroup analysis. Of course, there's a lot of data, so a lot to dig into, but we don't know yet. Also, with the patients, depending on adolescents and adults, [we are wondering whether there] are any differences? We are waiting for this sub-analysis. It's just the first result we have.

The quotes contained in this summary were edited for the purposes of clarity.

Passeron is a consultant for AbbVie, Almirall, Amgen, Bristol Myers Squibb, Calypso, Galderma, Incyte Corporation, Janssen, Eli Lilly, Novartis, Pfizer, Roivant, UCB, and VYNE Therapeutics. He has received grants and/or honoraria from AbbVie, ACM Pharma, Almirall, Amgen, Astellas, Bristol Myers Squibb, Calypso, Celgene, Galderma, Genzyme/Sanofi, GlaxoSmithKline, Incyte Corporation, Janssen, LEO Pharma, Eli Lilly, Novartis, Pfizer, Roivant, Sun Pharmaceuticals, Takeda, UCB, and VYNE Therapeutics. He is the cofounder of NIKAIA Pharmaceuticals and founder of SUNLUTION, and has patents on WNT agonists or GSK3b antagonist for repigmentation of vitiligo and the use of CXCR3B blockers in vitiligo.

References

1. Passeron T, Prajapati V, Seneschal J, et al. Efficacy and Safety of Upadacitinib in Adolescents and Adults for Treatment of Non-Segmental Vitiligo: Results of Two Phase 3 Studies (Viti-Up). Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.

2. Smith T. Upadacitinib Regulatory Applications Submitted for Adults, Adolescents with Vitiligo. HCPLive. February 3, 2026. Accessed March 30, 2026. https://www.hcplive.com/view/upadacitinib-regulatory-applications-submitted-adults-adolescents-vitiligo.