In the United States and the European Union, Ruxolitinib Powder is indicated for the treatment of disease-related splenomegaly or symptoms in adults with primary myelofibrosis (also known as chronic idiopathic myelofibrosis), post-polycythemia-vera myelofibrosis, or post-essential thrombocythaemia myelofibrosis. It is also indicated for the treatment of adults with polycythemia vera who are resistant to or intolerant of hydroxyurea. 941678-49-5 Ruxolitinib is also indicated for the treatment of steroid-refractory acute graft-versus-host disease in people who are twelve years of age and older, and for the treatment of chronic graft-versus-host disease (cGVHD) after the failure of one or two lines of systemic therapy in people twelve years of age and older.
Ruxolitinib cream is indicated for the topical treatment of mild to moderate atopic dermatitis (AD). Sold under the Opzelura brand in the United States
What are JAK inhibitors and how do they work?
In medicine, vitiligo is an autoimmune disease, which will cause the body's immune errors to attack melanocytes (melanocytes are cells that give skin color), which will lead to skin bleaching and whitening. JAKs belong to the family of cytoplasmic tyrosine kinases, whose function is to transduce signals mediated by cytokines (such as interferon). Through research, we found that the treatment principle of JAK inhibitor is that JAK protein is responsible for sending signals to the immune system to attack melanocytes during the formation of vitiligo. JAK inhibitors prevent JAK protein from doing so in this process, which in turn prevents the blind movement of the immune system, thereby preventing the formation of vitiligo.
The reason why this study is groundbreaking is that compared with the current treatment, this JAK treatment is more targeted and safer. It is a targeted treatment, which means that JAK inhibitors focus on preventing a part of the immune system, rather than attacking the immune system, and causing irreparable effects. This is very important, so when he suppresses the immune system, your strong body can still normally resist other infections, and its immunity is basically unaffected.
Which JAK inhibitors can we use?
At present, there are two kinds of drugs approved by the FDA for the treatment of inflammatory diseases-tofacitinib and ruxolitinib.
However, among these treatments, vitiligo treatment is not included at present (it has not been approved by FDA), but you can form primary vitiligo. Using this product can delay the spread of vitiligo.
The following is a detailed explanation of the two products
Tofacitinib
Tofacitinib is an FDA-approved oral drug for the treatment of rheumatoid arthritis and psoriatic arthritis. The reason for using Xeljanz in vitiligo is that it targets two JAK proteins (JAK 1 and TYK 2), including those specifically responsible for vitiligo.
A 2015 Research Report showed that the hand and face of a vitiligo patient were successfully recolored after treatment with tofacitinib. Other studies have shown that treatment of vitiligo with tofacitinib may require light. This is different from the current phototherapy for vitiligo. Even when low electric level light (light with very low energy) is combined with JAK inhibitor, it is enough to grow pigment.
Ruxolitinib
Ruxolitinib phosphate powder is another FDA-approved JAK inhibitor. Ruxolitinib phosphate targets two proteins including JAK 1, the latter of which is involved in the development of vitiligo.
In 2016, a dermatologist published an article on how oral Ruxolitinib phosphate 1092939-17-7 can quickly improve vitiligo, pointing out that the report of the association between facial melanosis in patients with vitiligo and patients with alopecia areata, that is, alopecia areata and vitiligo are caused by autoimmunity, resulting in patients with lesions from different parts. The relevant research is: that 12 patients with vitiligo were treated with 1.5% ruxolitinib cream, and the results were significantly different. At the same time, in the second experiment, it was found that patients with alopecia areata had significantly improved on the basis of the treatment of vitiligo.
Future development of JAK inhibitors in the treatment of vitiligo
Ranked by the direction of treatment research, the JAK kinase signaling pathway and related cytokines are the hot spots in the treatment of vitiligo, followed by antioxidant treatment and recolorization. It is reasonable to believe that local immunosuppressants may be an alternative to steroids in local vitiligo. New re colorants, such as basic fibroblast growth factor, including Alfa peptide, may be gradually replaced. JAK inhibitor is currently the most promising new drug for the treatment of vitiligo, and the effect of combined use with Nb UVB (311) is better. However, we still need to wait for more research results to evaluate the effectiveness, safety, and long-term effect of JAK.
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