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Patients with FST I\u2010III (\u2018light skin\u2019; <jats:italic>n<\/jats:italic>\u2009=\u2009247) and FST IV\u2010VI (\u2018dark skin\u2019; <jats:italic>n<\/jats:italic>\u2009=\u2009117) received once\u2010daily ritlecitinib 50\u2009mg (with\/without 4\u2010week loading dose), low\u2010dose ritlecitinib or placebo for 24\u2009weeks. At baseline, patients with light skin displayed higher CLM\u20101 and NCR1 serum levels than patients with dark skin (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). At 24\u2009weeks, ritlecitinib 50\u2009mg improved the extent of depigmentation measured by percent change from baseline in facial\u2010vitiligo area scoring index (placebo\u2010adjusted mean difference [90% CI]) in patients with light (\u221215.2 [\u221224.7, \u22125.8]; <jats:italic>p<\/jats:italic>\u2009=\u20090.004) and dark (\u221237.4 [\u221250.3, \u221224.4]; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) skin, with continuous re\u2010pigmentation through week 48. Treatment\u2010emergent adverse events were similar across FSTs. At weeks 4 and 24, ritlecitinib 50\u2009mg reduced CXCL11 serum levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in patients with light skin, whereas patients with dark skin had increased levels at week 4 (<jats:italic>p<\/jats:italic>\u2009=\u20090.05) and no significant change at week 24. Ritlecitinib 50\u2009mg decreased IL\u20109 and IL\u201022 expression levels in dark skin compared with light skin (qPCR; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). These differences in immune dysregulations may explain why NSV patients with dark skin respond to therapy earlier than patients with light skin.<\/jats:p>","DOI":"10.1111\/exd.15177","type":"journal-article","created":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T01:20:18Z","timestamp":1726881618000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Efficacy and safety of ritlecitinib in vitiligo patients across Fitzpatrick skin types with biomarker analyses"],"prefix":"10.1111","volume":"33","author":[{"given":"Elena","family":"Peeva","sequence":"first","affiliation":[{"name":"Inflammation and Immunology Research Unit Pfizer  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4338-2662","authenticated-orcid":false,"given":"Yuji","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Inflammation and Immunology Research Unit 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