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

Dr. Shravani Dali

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

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2025-12-30T20:30:47+05:30 | Updated On 31 Dec 2025 12:34 PM IST

Researchers have found in a new study that topical tofacitinib showed similar effectiveness to tacrolimus in treating localized vitiligo, with trends toward earlier patient-reported improvement and a more favorable safety profile, warranting confirmation in larger studies.

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.

Results: Of the patches treated with tofacitinib, 47% (n = 14/30) achieved treatment success vs. 37% (n = 11/30) of those treated with tacrolimus (P = 0.60). The median time to treatment success was shorter for patches treated with tofacitinib [8 weeks; 95% confidence interval (CI) 4.333–11.667] than for those treated with tacrolimus [12 weeks; 95% CI 8.301–15.699 (P = 0.18)]. Significant repigmentation was seen with both treatments, with 33% (n = 10) of tofacitinib-treated patches and 20% (n = 6) of those treated with tacrolimus achieving > 80% repigmentation. There were fewer adverse events with tofacitinib (n = 2) than with tacrolimus (n = 7). Facial lesions responded better than acral or trunk lesions with both treatments.

Topical tofacitinib demonstrated comparable efficacy to tacrolimus for localized vitiligo but showed trends toward earlier patient-reported response and a more favourable safety profile, a finding that could be validated in future studies with larger sample sizes.

Reference:

Hitaishi Mehta, Anuradha Bishnoi, Keshavamurthy Vinay, Muthu Sendhil Kumaran, Davinder Parsad, Comparative efficacy of topical tofacitinib versus topical tacrolimus in the treatment of localized vitiligo: a randomized investigator-blinded intraindividual trial, British Journal of Dermatology, Volume 193, Issue 6, December 2025, Pages 1112–1119, https://doi.org/10.1093/bjd/ljaf306

TopicalTofacitinibMatchesTacrolimusEfficacyPotentialSafetyAdvantagesLocalizedVitiligoStudyBritish Journal of Dermatology

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751