Condition

Vitiligo

Skin condition causing loss of pigmentation in patches

28.5M

People Affected

Active Trials

1.3M

New Cases/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Ruxolitinib Cream (Opzelura)

75% Effectiveness• 90% Confidence• 60% Safety• 1 trials• 1.2K participants

HIGH EvidenceModerate ValueDose: Apply thin layer twice daily to affected areas up to 20% BSA

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

3-6 months

Duration

Lifetime

Response Rate

40%

Remission Rate

10%

Number Needed to Treat (NNT)

Common Side Effects:

Acne: 20%

Application site pruritus: 10%

Nasopharyngitis: 5%

Annual Cost of Care

Drug Cost

$23,000

Monitoring

$300

Side Effects

$100

Total Annual

$23,400

Cost-Effectiveness

MODERATE

QALYs Gained

0.25

ICER

$119,726/QALY

Cost per Remission

$234,000

Cost per Responder

$58,500

Treatment Outcomes

Primary Outcomes

Facial Vitiligo Area Scoring Index (F-VASI)5.0 units (0-18 scale)

-70% (-3.5 units)

Total Vitiligo Area Scoring Index (T-VASI)10.0 units (0-100 scale)

-50% (-5.0 units)

Vitiligo Noticeability Scale (VNS)7/10 points (0-10 scale)

-40% (-2.8 points)

Secondary Benefits

Vitiligo Quality of Life Index (VitiQoL)25 points (0-30 scale)

-30% (-7.5 points)

Physician Global Assessment of Vitiligo (PGA-V)3/5 points (0=clearance, 5=worse)

-33% (-1 point)

Body Surface Area (BSA) affected by vitiligo10% of BSA

-45% (-4.5% of BSA)

Common Side Effects

Acne

+20%

Application site pruritus

+10%

Nasopharyngitis

+5%

Clinical Trial Phases:

Phase 3Phase 4

Narrowband UVB Phototherapy

70% Effectiveness• 95% Confidence• 70% Safety• 12 trials• 20K participants

HIGH EvidenceExcellent ValueDose: 2-3 sessions per week, gradually increasing dose from 200-300 mJ/cm²

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-3 months

Duration

6-24 months

Response Rate

60%

Remission Rate

25%

Number Needed to Treat (NNT)

Common Side Effects:

Erythema: 60%

Pruritus: 25%

Dryness: 20%

Increased skin cancer risk (long-term): 1%

Annual Cost of Care

Drug Cost

Monitoring

$300

Side Effects

$100

Total Annual

$8,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$40,000/QALY

Cost per Remission

$32,000

Cost per Responder

$13,333.33

Treatment Outcomes

Primary Outcomes

Repigmentation of Vitiligo Lesions0% (prior to treatment)

+55% (+55% repigmentation of affected areas)

Vitiligo Area Scoring Index (VASI)VASI score: 12

-40% (-4.8 points)

Affected Body Surface Area (BSA)8% BSA

-35% (-2.8% BSA)

Secondary Benefits

Dermatology Life Quality Index (DLQI)DLQI score: 14

-40% (-5.6 points)

Vitiligo Impact Scale (VIS-22)VIS-22 score: 65

-30% (-19.5 points)

Patient Satisfaction with AppearanceSatisfaction Scale: 3/10 (highly dissatisfied)

+100% (+3 points)

Common Side Effects

Erythema

+60%

Pruritus

+25%

Dryness

+20%

Clinical Trial Phases:

Phase 4

Excimer Laser/Light (308 nm)

68% Effectiveness• 85% Confidence• 70% Safety• 6 trials• 5K participants

MODERATE EvidenceExcellent ValueDose: 1-2 sessions per week, gradually increasing dose from 100-200 mJ/cm²

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 months

Duration

6-12 months

Response Rate

70%

Remission Rate

30%

Number Needed to Treat (NNT)

Common Side Effects:

Erythema: 50%

Blistering: 5%

Hyperpigmentation (transient): 10%

Annual Cost of Care

Drug Cost

Monitoring

$300

Side Effects

$100

Total Annual

$7,500

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$37,500/QALY

Cost per Remission

$25,000

Cost per Responder

$10,714.29

Treatment Outcomes

Primary Outcomes

Repigmentation within treated lesions0% repigmentation

+50% (+50% repigmentation)

Vitiligo Area Scoring Index (VASI) scoreVASI score: 8.0/100

-37.5% (-3.0 VASI points)

Physician Global Assessment (PGA) scorePGA score: 3/5 (moderate vitiligo)

-33.3% (-1 point (from moderate to mild))

Secondary Benefits

Dermatology Life Quality Index (DLQI)DLQI score: 12/30 (very large effect)

-41.7% (-5 DLQI points)

Patient Satisfaction with Appearance (VAS scale)VAS score: 40/100

+37.5% (+15 points)

Psychological Distress Score (HADS-Depression subscale)HADS-D score: 10/21 (borderline clinical depression)

-30% (-3 points)

Common Side Effects

Erythema

+50%

Blistering

+5%

Hyperpigmentation (transient)

+10%

Clinical Trial Phases:

Phase 4

Systemic Corticosteroid Pulse Therapy (e.g., Dexamethasone)

65% Effectiveness• 75% Confidence• 35% Safety• 30 trials• 2K participants

MODERATE EvidenceExcellent ValueDose: Dexamethasone 2.5-5 mg on 2 consecutive days per week

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 months

Duration

3-6 months

Response Rate

60%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Weight gain: 50%

Insomnia: 40%

Mood changes: 30%

Hypertension: 20%

Annual Cost of Care

Drug Cost

$100

Monitoring

$400

Side Effects

$200

Total Annual

$700

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$8,750/QALY

Cost per Remission

$14,000

Cost per Responder

$1,166.67

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+65%

Response Rate

+60%

Remission Rate

+5%

Common Side Effects

Weight gain

+50%

Insomnia

+40%

Mood changes

+30%

Clinical Trial Phases:

Phase 4

Topical Corticosteroids (e.g., Clobetasol Propionate)

55% Effectiveness• 90% Confidence• 35% Safety• 200 trials• 10K participants

HIGH EvidenceExcellent ValueDose: Apply thin film once or twice daily for 2-3 months, then 2-3 times per week

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

3-6 months

Duration

3-6 months continuous, then intermittent

Response Rate

45%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Skin atrophy: 15%

Telangiectasias: 8%

Acne: 5%

Annual Cost of Care

Drug Cost

$150

Monitoring

$200

Side Effects

$100

Total Annual

$450

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$4,500/QALY

Cost per Remission

$5,625

Cost per Responder

$1,000

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+55%

Response Rate

+45%

Remission Rate

+8%

Common Side Effects

Skin atrophy

+15%

Telangiectasias

+8%

Acne

+5%

Clinical Trial Phases:

Phase 4

Topical Calcineurin Inhibitors (e.g., Tacrolimus Ointment)

50% Effectiveness• 90% Confidence• 35% Safety• 70 trials• 4K participants

HIGH EvidenceExcellent ValueDose: Apply thin film once or twice daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

4-6 months

Duration

6-12 months or longer

Response Rate

40%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Application site burning: 30%

Application site pruritus: 15%

Erythema: 10%

Annual Cost of Care

Drug Cost

$600

Monitoring

$200

Side Effects

$100

Total Annual

$900

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$11,250/QALY

Cost per Remission

$12,857.14

Cost per Responder

$2,250

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+50%

Response Rate

+40%

Remission Rate

+7%

Common Side Effects

Application site burning

+30%

Application site pruritus

+15%

Erythema

+10%

Clinical Trial Phases:

Phase 4