(045) Vitiligo Disease Severity and Real-World Treatment Patterns

Background: Vitiligo is a condition that causes loss of skin color or pigmentation in the form of patches that can appear anywhere on the body and often become larger over time. Vitiligo affects approximately 1% of the global population. While the prevalence is similar by race and gender, the condition is more visible in individuals with darker skin tones. No treatment currently cures the condition, and disease management often aims to slow the speed of pigmentation loss and help cells produce melanin to restore color to the skin. Treatment strategy for vitiligo is not standardized; however, vitiligo severity may influence disease management in the real-world setting.

Objectives: To characterize vitiligo treatment patterns in the real-world setting by disease severity as measured by the 0 to 10-point visual analogue scale (VAS) for vitiligo severity.

Methods: Outpatient electronic health record data (2017-2024) from 6 specialty dermatology networks in the OMNY Health real-world data platform was accessed, and vitiligo patients were selected if they had at least 1 VAS measurement. Prescription orders, administrations, and procedures were assessed at the same visit as the VAS measurement. VAS values were grouped into the following categories: 0-1, 2-4, 5-7, 8-10. Percent of patient assessments by VAS category was calculated for topical corticosteroids (TCS), systemic corticosteroids (SCS), topical calcineurin inhibitors (TCI), ruxolitinib cream (from 2022 onward), and phototherapy.

Results: A total of 3,078 vitiligo patients with 3,779 VAS measurements were included (23%/35%/27%/15% for VAS 0-1/2-4/5-7/8-10). Distributions of gender (57% female), race (24% nonwhite), ethnicity (22% Hispanic or Latino), and age (mean: 48 years; standard deviation: 21 years) were similar between VAS categories. TCS and SCS prescriptions were not associated with vitiligo severity (range: 15-17% and 1-3%, respectively). However, with increasing vitiligo severity (VAS 0-1/2-4/5-7/8-10), ruxolitinib cream was prescribed increasingly (32%/35%/44%/46%) while TCIs (23%/23%/21%/15%)) and phototherapy (10%/6%/4%/3%) were used decreasingly.

Conclusions: While steroid use was not associated by vitiligo severity, disease management was influenced by severity for nonsteroidal treatment strategies. Analyses of clinical notes may be beneficial to understand reasons behind treatment strategies. Future analyses may focus on different treatment strategies and change in disease severity over time.