The first real drug which will likely be very effective in reversing vitiligo and keep it away is the current anti-CD122 antibody, which is also known as antibody blockade of il-15: the vitiligo research lab of UMass university had discovered that blocking a cytokine protein called IL-15 not only reverses vitiligo but it prevents it from coming back for a long time. This will be a durable and effective treatment for vitiligo. This drug does not target the same pathways of the already known jak inhibitors: those can reverse vitiligo but they turn off a lot more immune system than needed. The IL-15 blockade only turns off the specific part of immune system causing vitiligo, which translates in a lot less side effects than the jak inhibitors. We wrote a post about it, click here if you want to read it.
Some time ago I was reading the UMass blog and among the comments about an article talking about this subject someone posted that there is a drug for celiac disease which already targets IL-15, asking Dr Harris (the lead researcher whose lab created the anti-CD122 antibody) if this could also work. My first thought was a bit skeptical, that was until I read Dr Harris answer saying not only it is possible but they are actually already talking to them! Wow, I thought, at that point this would be worth further research! So… the drug is called AMG714 and I have found indeed that its purpose is to ease the effects of gluten on people suffering from celiac disease, and it just passed phase two clinical trial!! Now why is this exciting for vitiligo patients? Because this drug targets interleukin 15, the same as the famous anti-CD122 antibody that the UMass university lab is testing for vitiligo, which is the drug every vitiligo patient is waiting for. So, as a vulcan would say (yes, I am a star trek fan) “logic dictates” that this new drug for celiac disease could also, potentially, treat vitiligo very effectively. And since this drug already passed phase two clinical trial, does it mean it could be available to the public even before the anti-CD122? Nobody knows, but it’s possible: at the time of writing the anti-CD122 for vitiligo has yet to be tested on humans, where AMG714 has already passed phase two clinical trials so it’s certainly one step ahead.
You can find more information on AMG714 here: https://www.sciencedaily.com/releases/2018/05/180522082125.htm
Now, before getting too excited, some considerations:
Even if this drug can potentially be effective in treating vitiligo, it will not be FDA approved for the treatment of vitiligo at first. It’s designed and being tested only for celiac disease at the moment. In order to become FDA approved for vitiligo it would need to go through clinical trials for it too.
It is possible that the biggest benefit at first would come for those who are celiacs but also have vitiligo: as celiacs they could easily get this prescribed and, who knows, while easing the effects of gluten intolerance they could also find they are magically repigmenting! After all, this would not be the first time this happened (it happened with the Jak inhibitors we all know about) however given the amount of side effects of the JAK inhibitors (and their cost) there won’t be a clinical trial for them for the treatment of vitiligo. If it turns out that AMG714 can be effective treating vitiligo in some people, the idea of a clinical trial to make it FDA approved for vitiligo would be very viable. And if it does prove to treat vitiligo, maybe you can get a doctor to prescribe it to you anyway, although in this case you would have to pay for it as insurances won’t cover it unless you have celiac disease. The same is happening with the jak inhibitors: they are not FDA approved for vitiligo, yet since they work on vitiligo some people get a doctor to prescribe them anyway and they pay off their own pockets.
In conclusion, it’s really not only about this drug. The excitement in the vitiligo community stays in the fact that now the pathways of the immune system causing it have been identified and not only new drugs are in development specifically for vitiligo, but already existing drugs could be found effective in treating vitiligo while we wait for more targeted ones, which is what, after all, already happened with the JAK inhibitors and what is happening now with Apremilast. AMG714 though could potentially be a much better one as it targets more specific pathways and should have less side effects. About the costs it’s hard to predict but I don’t think it would be something unaffordable: if I could choose between paying 2000 dollars a month or avoid gluten I would probably choose the latter. So my own guess is it will be somewhat affordable or it won’t make too much sense.
Hopefully we will continue to discover new drugs which are already existing and work on vitiligo, while we wait for a specific one for vitiligo to be available.