Longer-lasting treatment for vitiligo could be available within the next few years. According to John Harris, M.D., Ph.D., director of the Vitiligo Clinic and Research Center at the University of Massachusetts Medical School, a new treatment targets and removes the cells responsible for developing the condition. He discussed this research at the American Academy of Dermatology Annual Meeting in Washington, D.C. “Compared to treating psoriasis, we’re in the Dark Ages when it comes to treating vitiligo,” he said. “We hope to be able to give vitiligo patients the treatment they deserve.” CURRENT TREATMENT JAK inhibitors, such as tofacitinib, are among the standard vitiligo treatments, targeting the cytokine interferon gamma. The treatment is available both orally or topically, and it blocks interferon gamma signaling. The problem, Harris said, is that the effect is temporary. “JAK inhibitors and other more conventional treatments work, but when you stop them, the disease comes right back,” he said. “And, it doesn’t just relapse. It returns in the exact same places as before.” WHAT’S HAPPENING Harris and other researchers have determined autoimmune memory cells, specifically resident memory T cells, are responsible for vitiligo relapses. These cells attack viral infections on the skin, and several cells linger to ward off future outbreaks. Current treatments turn these cells off, but they re-activate when medication use stops. “These cells wake back up, and they’re right there waiting,” he said. “And, the white spots return.” NEW THERAPY To offer longer-lasting therapy, the new treatment-in-testing targets the cytokine interleukin (IL)-15. It’s an antibody blockade that blocks IL-15 signaling. Results of a mouse study reveal that not only did the antibody turn off the signaling, but it also removed the resident memory T cells from the skin, eliminating the possibility of future relapse. “This is a drug that you’re, hopefully, going to see in the clinic within the next 5 years. It’s different from psoriasis and TNF inhibitors that were discovered to work by accident. We’re actually going to be able to tell you exactly how it’s working,” he said. “We’re hoping the IL-15 biologic will provide long-lasting results typically not seen in dermatology.” Ultimately, Harris said, this drug could fundamentally alter how dermatologists treat vitiligo patients. It could give them a tool designed to combat this specific condition. “The future is bright for vitiligo,” he said. “I like comparing it to other disease like atopic dermatitis and psoriasis because both of those diseases have targeted therapies that really have changed what it means to manage difficult patients. Vitiligo is next in line.” Source
