Topical Tofacitinib Matches Tacrolimus in Efficacy With Potential Safety Advantages in Localized Vitiligo: Study

Topical ruxolitinib was recently approved by the US Food and Drug Administration for the treatment of vitiligo. Studies comparing other topical Janus kinase inhibitors with established topical therapies like tacrolimus are lacking. A study was done to compare the efficacy and tolerability of topical tofacitinib and topical tacrolimus in patients with localized vitiligo using patient- and investigator-reported outcome measures. This was a prospective randomized investigator-blinded intraindividual single-centre comparative trial conducted over 16 weeks between January and December 2024. Thirty patients with 60 symmetrical vitiligo patches were enrolled. Eligible participants had slowly spreading, nonsegmental vitiligo affecting ≤ 5% of their body surface area. Patches were randomized to receive either topical tofacitinib 2% ointment or topical tacrolimus 0.1% ointment twice daily for 16 weeks. The primary outcome was percentage of patches achieving treatment success, defined as a Vitiligo Noticeability Scale (VNS) score of 4 (‘a lot less noticeable’) or 5 (‘no longer noticeable’). Secondary outcomes included time to treatment success, trends of VNS among groups, extent of repigmentation and adverse effects.