Efficacy and Safety Profile of Oral Tofacitinib in Non-Segmental Vitiligo

Abstract Background: Vitiligo is a chronic disease that is often challenging to treat. Melanocyte destruction in vitiligo is mediated by immune pathways involving IFN-γ and CD8+ T cells. Tofacitinib, a Janus kinase (JAK) 1/3 inhibitor, can be a promising treatment for vitiligo due to its potential to inhibit IFN-γ signaling. We retrospectively reviewed the records of 16 patients (6 men, 10 women; mean age 39.7 years) with nonsegmental vitiligo refractory to conventional therapies who were treated with oral tofacitinib along with topical tacrolimus and phototherapy. Aims: To evaluate the efficacy and adverse effects of the JAK1/3 inhibitor, oral tofacitinib, in the treatment of nonsegmental vitiligo. Methods: We retrospectively reviewed the records of 16 patients (6 men, 10 women; mean age: 39.7 years) with nonsegmental vitiligo refractory to conventional therapies who were treated with oral tofacitinib along with topical tacrolimus and phototherapy. Improvement was assessed using Vitiligo Area Scoring Index (VASI) at weeks 6, 12, and 24. Hemogram, lipid profile, liver, and renal function tests were monitored during the treatment period. Results: Improvement was assessed using Vitiligo Area Scoring Index (VASI) at weeks 6, 12, and 24. Mean VASI scores improved from 5.038 at baseline to 1.269 at 24 weeks, with 13 patients (81.25%) achieving at least 50% improvement. Transient leukopenia was observed in 3 patients, and one patient developed palmar warts. Conclusions: Oral tofacitinib shows significant potential in the management of nonsegmental vitiligo, in patients unresponsive to conventional therapies especially in combination with phototherapy. No significant adverse effects were observed during the follow up period other than a transient leukopenia in three patients and palmar warts in one patient.