OBJECTIVES: The objective of this research was to characterize real-world treatment patterns among vitiligo patients in diverse healthcare delivery settings in the United States (US) given the lack of Food and Drug Administration-approved treatments.

METHODS: Patients from 6 specialty dermatology networks and 4 integrated delivery networks within the OMNY Health Database with any indication of vitiligo (diagnosis code: L80) from 2012-2021 were included. Demographic characteristics were tabulated at first vitiligo diagnosis. Percentages of patients with prescriptions for any of the following therapy classes were computed: topical corticosteroids (TCS), topical calcineurin inhibitors (TCI), topical vitamin D analogs (TVDA), phototherapy, systemic corticosteroids (SCS), systemic immunosuppressants (SIS), janus kinase inhibitors (JAKI), and afamelanotide. Secular trends in annual treatment patterns were described.

RESULTS: Across all years, a total of 25,724 vitiligo patients with prescription and procedure data were included. Distributions of gender (55% female), race (76% White, 10% Black, 15% Other among known categories), age (36% ≥ 60 years, 49% 20-60 years, 15% < 20 years), and region (61% Southeast, 16% West, 10% Mid-Atlantic/Northeast, 13% Midwest) were as expected. Patients prescribed TCS and TCI increased from 24% to 39% and from 9% to 25%, respectively, from 2012 to 2021. Considerable use of phototherapy observed in 2012 (8.8%) declined steadily and bottomed in 2020 (4.3%). SCS and TVDA were used more sparingly with patient prescriptions peaking in 2018 (2.1% and 1.5%, respectively) followed by slight declines. SIS, JAKI, and afamelanotide use were negligible throughout the observation period.

CONCLUSIONS: Results provide insights into real-world treatment patterns for vitiligo within a diverse set of US healthcare settings. Increased use of TCS and TCI coincided with decreased use of phototherapy. As new treatments are developed and introduced, future analyses would be helpful to understand uptake of therapies and prescription patterns among vitiligo patients.