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Prevalence and Clinical Characteristics of Vitiligo-Associated Hearing Loss Among Patients in a Phase 2 Clinical Trial of Povorcitinib
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DOI：10.1007/s13555-026-01789-9.png)
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Abstract
En 中文
Patients with vitiligo reportedly have an increased risk of sensorineural hearing loss (SNHL), driven by the loss of extracutaneous melanocytes in the inner ear. In a phase 2 dose-ranging study, the oral, selective Janus kinase 1 inhibitor povorcitinib demonstrated substantial repigmentation in patients with extensive nonsegmental vitiligo through 52 weeks of treatment. This exploratory post hoc analysis of the phase 2 study evaluated the prevalence of hearing loss among enrolled patients and examined their associated demographic and clinical characteristics, as well as their audiometric response to povorcitinib. SNHL was defined as a bone-conduction threshold of ≥ 25 dB in either ear and was assessed using all-frequencies average (AFA: 250, 500, 1000, 2000, 3000, 4000, 6000, 8000 Hz), pure-tone average (PTA: 500, 1000, 2000, 4000 Hz), and high-frequencies average (HFA: 2000, 3000, 4000, 6000, 8000 Hz). Of 162 patients assessed for hearing loss, SNHL prevalence at baseline was 10.5% (AFA), 11.7% (PTA), and 14.2% (HFA). Patients with versus without SNHL were significantly older and had significantly greater facial involvement. Following up to 52 weeks of povorcitinib treatment, bone-conduction hearing thresholds improved across all frequency ranges, although no definitive conclusions can be drawn. At week 52, mean percentage change from baseline in the left and right ears was as follows: AFA, − 18.7% (P = 0.08) and − 16.1% (P = 0.10); PTA, − 13.9% (P = 0.18) and − 7.2% (P = 0.25); and HFA, − 11.0% (P = 0.21) and − 12.6% (P = 0.18), respectively. SNHL was common in this patient population, suggesting that audiologic evaluation may be appropriate for some patients with vitiligo to support early detection and management of hearing loss. Changes in hearing with povorcitinib treatment require confirmation in larger patient populations. Graphical abstract available for this article. ClinicalTrials.gov identifier, NCT04818346. Vitiligo is a disease that causes patches of skin to lose color. The same cells that give skin its color, called melanocytes, are also found in the inner ear and help with hearing. When these cells are lost, it may lead to a type of hearing loss called sensorineural hearing loss. This means patients with vitiligo may be at higher risk for hearing loss. In a recent study, patients with widespread vitiligo took an oral medicine called povorcitinib and saw a significant return of their skin color, which means that their melanocytes were being restored. The analysis described here looked at data from that same study to see how many patients had hearing loss at the beginning of the study and whether their hearing changed after treatment. It also looked at any patient traits that might be linked to hearing loss, such as age or how much of their skin had lost color from vitiligo. At the start of the study, just over one in ten patients had at least some sensorineural hearing loss. The patients with hearing loss were generally older and had more color loss of the skin on their faces than patients who did not have hearing loss. After up to a year of treatment with povorcitinib, patients showed some improvement in hearing, but this needs to be confirmed in larger studies. These findings suggest that hearing loss is relatively common in patients with vitiligo, so regular hearing checkups could be helpful for them.
Keywords:
Hearing loss
INCB054707
Inner ear
JAK1 inhibitor
Janus kinase
Melanocytes
Nonsegmental vitiligo
Povorcitinib
Sensorineural hearing loss
Vitiligo
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