Three-dimensional imaging for facial vitiligo: Results from a phase 2 randomized controlled trial investigating upadacitinib in patients with vitiligo

BACKGROUND: Upadacitinib (UPA), an oral selective Jak inhibitor, showed significantly greater facial repigmentation than placebo as assessed by Facial Vitiligo Area Scoring Index (F-VASI) in a phase 2 clinical trial. A nested substudy explored a 3-dimensional (3D) imaging platform as an objective tool to quantify facial vitiligo repigmentation. METHODS: Adults with nonsegmental vitiligo received 6, 11, or 22 mg UPA or placebo for 24 weeks (period 1). For weeks 24-52 (period 2), UPA-treated patients continued UPA at assigned doses; patients receiving placebo switched to 11 or 22 mg UPA. In this substudy, efficacy was assessed by the percentage change from baseline in facial vitiligo area with 3D imaging and F-VASI. RESULTS: The substudy included 27 patients. Patients receiving UPA showed facial repigmentation at weeks 24 and 52 as assessed by 3D imaging and F-VASI. There was a high correlation between 3D imaging and F-VASI measurements at baseline (r = 0.85; P < .0001). At week 24, there was a high correlation (r = 0.71; P = .0003) between the percentage change from baseline in 3D imaging and F-VASI measurements, which diminished by week 52 (r = 0.01; P = .9600). CONCLUSIONS: 3D imaging shows potential as an objective tool for evaluating changes in facial vitiligo after UPA treatment.