Oral Tofacitinib arrests vitiligo progression and induces repigmentation when combined with phototherapy: Study
Vitiligo is a chronic autoimmune disease that results from the loss of melanocytes, leading to disfiguring skin lesions. This skin condition causes anxiety and depression, and treatment aims to halt the disease progression, and repigment affected areas. Topical medications and NB-UVB phototherapy are typically used, but in some cases, these treatments may not be effective. Systemic glucocorticoid treatment may help, but these have potential side effects. Other systemic treatments, such as methotrexate, minocycline, ciclosporin, and JAK inhibitors, may also be used as monotherapy or adjunctive therapy.
A recent study published in Dermatologic Therapy concluded that Tofacitinib could be a new treatment option for progressive vitiligo patients non-responsive to traditional treatment, as it may halt progression and promote repigmentation when combined with phototherapy.
JAK inhibitor has demonstrated therapeutic efficacy on vitiligo, but more data for vitiligo progression needs to be available as data in this context remain scarce.
This retrospective study evaluated the efficacy and safety of oral Tofacitinib in 25 refractory progressive vitiligo patients. These patients reported failure to previous steroid treatments.
Key findings from the study are:
- 16/25 patients, constituting 64%, noted stopping disease progression.
- Nearly half of the 16 cases halted progression within one month.
- 40% (n=10) of patients had repigmentation in varying degrees.
- Combination with phototherapy affected the repigmentation rate.
Oral Tofacitinib might be a potentially effective treatment for intractable progressive vitiligo.
A comparison of Tofacitinib with other systemic treatments, such as oral corticosteroids or methotrexate, would have been more beneficial. They said we anticipate future high-quality studies providing high-level evidence treating vitiligo cases with JAK inhibitors.
Study limitations include retrospective study design, single-centre study and small sample size.
Reference:
Sun, X., Sheng, A., & Xu, A. (2024). Tofacitinib for the Treatment of Refractory Progressive Vitiligo: A Retrospective Case series. Dermatologic Therapy, 2024, 1–5. https://doi.org/10.1155/2024/9944826
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