Summary

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• This summary is based on the review of 13 systematic review(s)/meta-analysis(es). ^[1-13]
• Vitiligo: Topical ruxolitinib showed a significant improvement in facial vitiligo, with 52% of participants achieving at least 75% improvement in the Facial Vitiligo Area Scoring Index (F-VASI) over 52 weeks (odds ratio (OR) for F-VASI75 = 4.34 [95% confidence interval (CI) 2.67-7.06]; OR for F-VASI50 = 4.71 [95% CI 3.24-6.84]). Additionally, for total body vitiligo, there was an increased likelihood of achieving at least 50% improvement in the Total Vitiligo Area Scoring Index (T-VASI50: OR 4.47 [95% CI 2.52-7.92]), with a mean reduction of -20.22 in T-VASI scores [95% CI -23.11 to -17.33].
• Eczema (Atopic Dermatitis): Ruxolitinib 1.5% twice daily led to notable improvements in eczema symptoms, showing a significant increase in achieving Eczema Area and Severity Index (EASI-75) (relative risk (RR) = 4.14 [95% CI 3.06-5.61]) and improved pruritus (the Peak Pruritus Numerical Rating Scale (NRS): RR = 4.08 [95% CI 2.86-5.81]). It was effective for mild to moderate atopic dermatitis and demonstrated comparable efficacy to other Janus kinase (JAK) inhibitors and Phosphodiesterase-4 (PDE-4) inhibitors.
• Comparison with Other Drugs for Eczema: Ruxolitinib 1.5% had comparable effectiveness to delgocitinib and tacrolimus 0.1% in achieving Investigator Global Assessment (IGA) scores. Potent topical steroids, tacrolimus 0.1%, and JAK inhibitors consistently ranked as the most effective treatments for eczema.
• Subgroup Variability in Vitiligo: The response was highest in facial vitiligo (70% response) compared to vitiligo on extremities (27.3%) or torso/non-sun-exposed areas (13.6%), with concurrent phototherapy enhancing the response across all areas.
• Vitiligo: Ruxolitinib demonstrated no significant increase in treatment-emergent adverse events (TEAEs) compared to the vehicle (RR 1.46 [95% CI 0.85-2.49]), indicating a favorable safety profile.
• Eczema (Atopic Dermatitis): Local application site reactions were most common with tacrolimus 0.1% and crisaborole 2%, while ruxolitinib 1.5% showed no statistically significant differences in local reactions compared to other JAK inhibitors. Long-term use of topical steroids, however, was associated with an increased risk of skin thinning (6-60 months), though short-term use did not show this effect.
• Population Types and Subgroup Considerations: For vitiligo, pediatric, adolescent, and young adult patients demonstrated favorable outcomes with topical ruxolitinib, especially in facial vitiligo and when combined with phototherapy, which significantly enhanced response rates. In eczema (atopic dermatitis), ruxolitinib was effective across diverse demographic groups, including children under 12 years and various ethnic populations, with tacrolimus 0.1% and crisaborole 2% being more likely to cause local application-site reactions.