JANUS KINASE INHIBITORS COMBINED WITH NARROWBAND UVB PHOTOTHERAPY FOR VITILIGO: A SYSTEMATIC REVIEW

Vitiligo is a chronic autoimmune depigmenting disorder characterized by immune-mediated melanocyte destruction, with involvement of interferon-γ–JAK–STAT signaling pathways. Narrowband ultraviolet B (NB-UVB) phototherapy is an established treatment option; however, repigmentation responses are often incomplete. JAK inhibitors have emerged as potential adjunctive therapies, and their combination with NB-UVB may provide complementary anti-inflammatory and melanocyte-stimulatory effects. The research aims to summarize the available clinical evidence regarding the efficacy and safety of JAK inhibitors combined with NB-UVB phototherapy for the treatment of vitiligo. A systematic literature search of PubMed/MEDLINE-indexed studies was performed by a single reviewer up to July 15, 2026, using terms related to JAK inhibitors, individual JAK inhibitor agents, vitiligo, and NB-UVB phototherapy. Additional studies were identified through backward citation searching. Study selection and data extraction were performed by a single reviewer without prospective protocol registration or independent duplicate screening. Fourteen studies met the inclusion criteria. Across different JAK inhibitors and study designs, combination therapy generally showed higher repigmentation outcomes compared with monotherapy or baseline treatment approaches. Controlled studies reported improved VASI outcomes with combinations involving ruxolitinib, baricitinib, and ritlecitinib compared with comparator groups. An independent meta-analysis of randomized controlled trials also suggested that JAK inhibitor and NB-UVB combination therapy may improve repigmentation outcomes compared with NB-UVB alone. Adverse events were generally mild and consistent with the known safety profiles of the therapies, including local irritation, acneiform eruptions, and transient laboratory abnormalities. No treatment-related serious adverse events attributable to the combination therapy were reported in the included studies. Current evidence suggests that combining JAK inhibitors with NB-UVB may improve repigmentation outcomes in patients with vitiligo. However, the available evidence remains limited by small sample sizes, heterogeneous treatment protocols, and methodological limitations of the included studies. Further large-scale randomized trials with standardized outcomes and longer follow-up are needed to clarify the optimal role of combination therapy in clinical practice.