A JAMA study of nearly 25,000 vitiligo patients reveals major gaps in real-world treatment duration and consistency.
In an HCPLive Q&A interview, Genevieve Gauthier, MSc, highlighted findings from a recent JAMA study examining treatment patterns among nearly 25,000 patients with vitiligo, including how often individuals go untreated after diagnosis and how long they typically stay on therapy once their treatment begins.2
Gauthier also explores how treatment approaches differ across age groups, why visible lesions may carry a heightened psychosocial burden, and what these real-world patterns reveal about unmet needs in vitiligo care. The following Q&A highlights Gauthier’s responses to HCPLive inquiries regarding these findings:
Gauthier: Our study described what’s happening rather than the reasons behind individual treatment decisions, so I can’t speak in detail to the “why.” What makes this finding particularly meaningful is the context: these were patients who had been diagnosed, who had entered the healthcare system, and in many cases were diagnosed by a dermatologist (46.4%), and still a substantial share didn’t go on to treatment.
Additionally, among patients who were treated, therapy duration was relatively short, a median of roughly two to four months for first and second lines of therapy, and treatment sequences varied substantially from patient to patient. In totality, those findings suggest that current treatment approaches may not, in some vitiligo patients, be meeting patients' needs over the long term.
Gauthier: We were not able to determine the specific reasons why patients discontinued or switched therapies as this information was not available in the databases we used for this study. However, when considered alongside the high variability observed in treatment sequences, these findings may suggest that some patients with vitiligo face limited long-term treatment options and a lack of standardized, sustained approaches to care.
In real-world clinical practice, these patterns could be influenced by multiple factors, including heterogeneity in patient response, tolerability considerations, challenges with long-term adherence, and the overall complexity of managing a chronic condition like vitiligo. That being said, additional studies would be warranted to better understand what is driving treatment discontinuation and switch in vitiligo patients and inform future research and development of durable treatment strategies.
Gauthier: While we didn’t measure quality-of-life in our study, there is a substantial body of literature showing that vitiligo carries a significant psychosocial burden impacting patients’ quality of life. Studies have also demonstrated that patients with facial lesions have a higher psychosocial burden vs. those without facial lesions.
To me the fact that most patients in our study had visible lesions on the face underscores the need for clinicians to take a more holistic approach to vitiligo care – an approach that goes beyond clinical measures and fully considers the broader patient experience
Gauthier: Results from our study showed that children and adolescents were more likely than adults to receive topical treatments, while systemic treatments, including oral corticosteroids, were more common in adults. As a first line, topical-only treatment was used in roughly 90% of children and 80% of adolescents, versus about 60% of adults. These findings weren’t surprising as they are consistent with evidence supporting their use in pediatric patients.
Gauthier: The most important takeaway to me is that there are still clear gaps in vitiligo care and significant room to improve outcomes and quality of life in patients living with vitiligo. Across nearly 25,000 patients, about one in three diagnosed patients didn’t go on to receive treatment; those who were treated tended to stay on therapy only a few months, and treatment sequences varied widely. Those patterns held across age groups and disease extent, and are in line with other recent real-world analyses, providing a coherent picture of how vitiligo is being managed in the US today.
Overall, these findings highlight a lack of standardized approaches, and that current treatment approaches may not, in some patients, fully address patients’ long-term needs. Insights like these could help inform future research and clinical practice and, ultimately, potentially contribute to improving outcomes for people living with vitiligo.
Disclosures: Gauthier reported employment with Pfizer during the conduct of the study.
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