Clinical Characteristics and Treatment Patterns in Patients With Vitiligo

Importance: Vitiligo is a chronic autoimmune disease characterized by loss of pigment in the skin, hair, or both, which can impact quality of life. Objective: To describe the demographic and clinical characteristics of patients with vitiligo and to characterize vitiligo treatment patterns, by vitiligo extent and age. Design, Setting, and Participants: This retrospective cohort study analyzed deidentified data from the linked Komodo Healthcare Map and OMNY Health Foundation databases. The linked databases capture health care and pharmacy claims and electronic health record data for patients with vitiligo receiving care in US dermatology practices and across all other settings. The index date was the date of first observed diagnosis of vitiligo during the index identification period (January 1, 2018, to August 31, 2023), allowing for 3 months or more of follow-up. Eligible patients were those with diagnosed vitiligo and 365 days or more of continuous health care plan enrollment (or eligibility proxy for patients with open claims) before index date. Patients missing age data or without any follow-up were excluded. Patients were stratified into cohorts by age and vitiligo percentage of body surface area (BSA) involvement (≤10%, >10%, and no BSA assessment) at index. The data analysis was conducted between April 2024 and August 2024. Main Outcomes and Measures: Baseline demographics, baseline clinical characteristics, and vitiligo treatment patterns following index date were described. Results: Of the 24 949 included patients, 1329 (5.3%) had a BSA assessment at index (963 had ≤10% BSA involvement; 366 had >10%). Most patients (n = 21 996 88.2%) were 18 years and older and female (n = 14 057 56.3%). The face was the most frequently affected area at index, impacting 5482 of 16 674 patients (32.9%) with reported location of vitiligo. Across BSA groups, 27% (6308 of 23 620 without BSA assessment) to 32% (310 of 963 with ≤10% BSA involvement) of patients did not receive treatment for vitiligo during follow-up. The most common treatments following index were topical and oral corticosteroids and topical calcineurin inhibitors/phosphodiesterase-4 inhibitors, with no substantial differences across BSA groups during follow-up. Topical treatments were prescribed more frequently to children and adolescents vs adults, while systemic treatments were prescribed more to adults. High variability across treatment sequences was observed. Median therapy duration ranged from 1.8 (95% CI, 1.6-2.1) months to 4.1 (95% CI, 3.7-4.4) months, for first and second lines of treatment depending on treatment type. Conclusions and Relevance: This cohort study reported treatment patterns in patients with vitiligo. A high proportion of patients with vitiligo did not receive treatment during follow-up, and therapy duration was relatively short.