Vitiligo associated with type 2 immune inhibitors: FAERS analysis and literature review

With the widespread use of type 2 immune response inhibitors (IRIs), there is growing concern about their association with the occurrence of vitiligo. This study aimed to comprehensively search for cases of vitiligo associated with type 2 IRIs in the US Food and Drug Administration Adverse Event Reporting System (FAERS). We retrieved the clinical characteristics of cases from January 2004 to September 2024 from the FAERS database. Disproportionality and Bayesian analyses were conducted to detect signals for vitiligo associated with type 2 IRIs. A total of 86 cases of vitiligo were identified in association with these inhibitors. The mean onset time was 326 days. Vitiligo associated with dupilumab was the most common (81.4%), with the highest reporting odds ratio (2.67, 95% confidence interval  2.11-3.4), proportional reporting ratio (2.67, χ² = 70.59), information component (1.38, [IC025 = 1.09), and empirical Bayes geometric mean (2.61, EBGM05 = 2.14). The link between vitiligo and type 2 IRIs underscores the need for continued pharmacovigilance to better understand these drugs and the incidence of related conditions.