UAE's approval of first licensed oral treatment for non-segmental vitiligo ‘a real turning point'

8 Sep 2026 20:42 BATOOL GHAITH (ABU DHABI)The UAE's approval of the first licensed oral treatment for patients with non-segmental vitiligo who require systemic therapy could significantly change the management widespread or actively progressing disease, Abu Dhabi dermatologists said.The Emirates Drug Establishment (EDE) has approved a new therapeutic indication for RINVOQ, or upadacitinib, for adults and adolescents aged 12 and above with non-segmental vitiligo whose condition requires systemic treatment.The UAE became the first individual country to approve the expanded indication, according to the EDE.Speaking to Aletihad, dermatologists said that the significance lies particularly in giving patients with extensive disease a licensed treatment that works systemically rather than requiring each affected area to be treated separately.'For patients with widespread or fast-spreading vitiligo, this is a real turning point,' Dr James Zachariah, Specialist Dermatology and Head of Department at Medeor Hospital in Abu Dhabi said.Vitiligo is a chronic autoimmune condition in which pigment-producing melanocytes are lost, resulting in white or depigmented patches of skin. Global estimates generally put its prevalence at around 0.5% to 1% of the population, although figures vary between studies and populations. Targeting the Underlying ConditionDr Farhan Rasool, Clinical Lead and Consultant Dermatology at Burjeel Medical City in Abu Dhabi, said the new approval was particularly important for patients with more extensive non-segmental vitiligo. He noted that until now, management has largely relied on topical corticosteroids or calcineurin inhibitors, phototherapy and more recently targeted topical treatments including JAK inhibitors.'These treatments can work well for selected patients, but applying medication over large areas can be difficult, and regular phototherapy requires repeated hospital or clinic visits over many months,' he explained.Dr Zachariah agreed, saying that oral treatment addresses that problem by working through the bloodstream to target the underlying condition rather than treating the skin patch by patch.Dr Rasool said a once-daily systemic treatment gives dermatologists another option when a patient's condition is sufficiently widespread or active to require treatment beyond creams. However, he stressed that the medicine would not be appropriate for every person with vitiligo. 'It would not replace topical therapy or phototherapy for every patient. Rather, it adds an important option for those in whom systemic treatment is appropriate,' he noted. Who Could Benefit?Both specialists said patients with extensive or progressively spreading non-segmental vitiligo are among those most likely to be considered for systemic treatment. Dr Zachariah said potential candidates include people with widespread disease, patches that are actively spreading, involvement of areas such as the trunk or limbs or patients who have already tried creams and phototherapy with limited success. 'It is not likely to be the first choice for someone with just a few small, stable patches,' he said.Dr Rasool said dermatologists would assess more than the surface area affected before recommending an oral treatment. Disease activity, the location of affected areas, previous treatment response, psychological impact, associated medical conditions and individual risk factors all form part of the decision, he added.'Because RINVOQ is a systemic JAK inhibitor, patients also require appropriate assessment and continued medical monitoring,' Dr Rasool said, noting that this includes reviewing a patient's medical history and risk factors, alongside baseline screening and laboratory monitoring.They also cautioned that having an oral medicine should not create expectations of immediate repigmentation.'Vitiligo is a chronic autoimmune condition, and repigmentation is gradual, treatment generally needs to be continued for a meaningful period before the response can be properly assessed,' Dr Rasool said.The doctors said a new treatment option could also encourage patients who have previously assumed that little can be done for vitiligo to seek specialist care.'There is still a common but outdated belief that vitiligo cannot really be treated or that it is just a cosmetic concern,' Dr Zachariah said.The EDE has also urged people who notice unusual changes in skin colour to seek specialist medical advice, allowing appropriate diagnosis, assessment and treatment selection. Vitiligo is encountered regularly among both adults and children in UAE dermatology clinics, according to Dr Rasool. An Early Adopter of Pharmaceutical InnovationThe approval of the medication in the UAE highlights the speed at which certain new pharmaceutical indications can reach patients in the country, the specialists said. Dr Zachariah noted that the decision reflects the country's regulatory approach to positioning itself as an early adopter of pharmaceutical innovation. He said streamlined review processes, faster decision-making and the ability to consider established international data and safety records can help new treatments reach the market sooner.He also pointed to broader implications for the UAE's healthcare positioning, including its ambitions in pharmaceutical investment and medical tourism.Dr Rasool said the regulatory environment increasingly places emphasis on both pharmaceutical innovation and timely patient access.'The regulatory authorities have mechanisms for the accelerated assessment of innovative medicines of therapeutic importance,' he said.From a clinical perspective, dermatologists in the UAE have increasingly gained relatively early access to newer treatments across the specialty, Dr Rasool added, noting that wider selection can allow physicians to tailor treatment more closely to disease severity, previous response and the circumstances of individual patients.Dr Rasool also emphasised that speed of access must continue to go hand in hand with rigorous evaluation. 'What is equally important is that rapid access remains linked to appropriate regulatory evaluation of efficacy, safety and quality,' he said.