Advanced Therapy Medicinal Products in Vitiligo: Current Status, Future Prospects, and Approved Treatments

Vitiligo, affecting 0.2-1.8% of the global population, is primarily treated with topical corticosteroids and calcineurin inhibitors, which have significant side effects. Phototherapies offer limited effectiveness without serious side effects. Advanced therapy medicinal products (ATMPs) have emerged as promising treatments due to their optimal effectiveness and minimal side effects. Current ATMPs for vitiligo include non-cultured epidermal cells, melanocytes, and hair follicle melanocytes, showing promise in patients unresponsive to other treatments. Additionally, mesenchymal stem cells and multi-lineage differentiating stress enduring cells are potential new therapies. The Iranian Food and Drug Administration recently approved the first cell-based product for vitiligo, an autologous suspension of keratinocytes and melanocytes. Despite their efficiency and potential long-term cost-effectiveness, the affordability of ATMPs remains a challenge, which could be addressed through insurance and payment programs.