Abstract: 【Abstract】 Objective To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo. Methods Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily （2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg） in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index （F-VASI） and total body VASI （T-VASI） at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course. Results Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions （F-VASI 50）, 1 patient achieved F-VASI 75 （75% ~ < 90% improvement）, and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 （≥ 90% improvement）, and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment. Conclusion The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Key words: Vitiligo, Janus kinase inhibitors, Baricitinib, Ruxolitinib, Treatment outcome, Efficacy, Safety