3 Future Treatments for Vitiligo
For people with vitiligo affecting over half their body, adults who got vitiligo as a child when treatment wasn’t available, or those with adverse reactions to current treatment, it may seem like vitiligo is something they will have to deal with forever. There are three treatment methods that are currently being studied that could change the way vitiligo is treated and can even reverse the auto-immune disease for people who have widespread vitiligo. 

Afamelanotide- A New Drug Application was filed in June of 2018 for Afamelanotide, a drug that is currently proposed to treat a rare blood disorder called erythropoietic protoporphyria (EPP). When patients with EPP are exposed to light that has a severe biochemical reaction. The drug is waiting to receive FDA approval; however, if approved, it is very likely that Afamelanotide could be used to treat vitiligo in the future because the drug stimulates melanin in the skin which helps to shield skin from light. Afamelanotide is a hormone that is transmitted through an implant placed under the skin. Each implant lasts for two months and causes the skin to turn darker over time. The treatment was first developed to be a sunless tanner at the University of Arizona. Afamelanotide is already available in Europe for treatment of EPP. 

Prostaglandin E2- The National Library of Medicine published a report in 2009 that studies have confirmed that Prostaglandin E2 has stimulating effects on melanocytes and regulating their proliferation. During the study, fifty-six patients with diagnosed stable vitiligo applied the medication via gel twice daily for six months. More than seventy percent of the patients achieved repigmentation. Eight patients had complete repigmentation, and twenty-two patients had an excellent response of more than seventy-five percent repigmentation. Most patients began seeing results after two months. Another study was completed in 2018 with similar results. 

Tofacitinib- Janus Kinase (JAK) inhibitors are a promising form of targeted therapy for vitiligo. Tofacitinib is a JAK 1/3 inhibitor combined with a low-dose UV-B. Patients who took part in the study by JAMA Dermatology two Tofacitinib twice daily combined with UV light therapy twice weekly and achieved full repigmentation on the areas treated. 

There is another therapy currently being studied that may receive clinical trial approval on humans in 2019. A Scientist named John Harris at the Vitiligo Clinic and Research Center at the University of Massachusetts Medical School has been studying skin memory cells and has developed a treatment that can make existing treatments for vitiligo such as light therapy, be long-lasting. 

They began studying skin samples of vitiligo patches. The samples were sent to several different labs which all concluded that skin with vitiligo has memory cells that protect the skin from viral infections that it has been exposed to previously, so that response and healing is quicker. Because vitiligo is an autoimmune disease, the immune system misfires at melanin cells, killing them. When patients receive light therapy treatment, that works, within a year in most cases, the white patches will begin to return due to the memory cells. 

To combat this idea John Harris and his team have discovered that memory cells that cause vitiligo require the IL-15 protein to survive. The team at the research center created an antibody for IL-15 and successfully was able to eradicate the memory cells in mice with vitiligo. The brown pigment of the mice returned completed after only two weeks of treatment and lasted for months. 

This study suggests that if humans with vitiligo can be effectively treated with the antibody, this treatment could provide much longer lasting results for light therapy treatment.