A study on the therapeutic response of vitiligo to tofacitinib in tertiary care centre

Background: Vitiligo is a common acquired depigmentation disorder resulting from the progressive loss of melanocytes and is characterized clinically by milky‐white sharply demarcated macules. Vitiligo is a chronic autoimmune disease, which affects around 0.5% of the population
Material and methods: Place of study: Department of Dermatology, Nalanda Medical College & Hospital, Patna. Type of study: Interventional Study. Study Design: Intervention Model: Single Group Assignment, Primary Purpose: Treatment, Intervention Model Description: A prospective single centre study. 30 clinically diagnosed patients of vitiligo, aged 18 years and older. Interventions: 5mg of tofacitinib tablet twice daily for three months. Experimental treatment: All 32 receive 5mg of tofacitinib tablet twice daily for three months. Actual Study Start Date: April 2020, Estimated Study Completion Date: January 2021.
Results: The mean age of the patients was 44.35 ± 10.78 years, about 36.67% belongs to age group 40-49 years & about 21 (70.00%) patients were male and rests 9 (30.00%) were female. mean duration of vitiligo in studied patients was 08.45 ± 3.24 years while presence of thyroid and steroid use in same patients were 10.00% and 06.67% respectively. Based on character of vitiligo patients about 56.67% patients suffered from general vitiligo, 26.67% had acrofacial, 6.68% segmental vitiligo and 10.00% suffered from mucosal vitiligo. majority 23 (76.67%) of patients had no experience of adverse effects and rest 7 (23.33%) patients experienced adverse effects as a result from oral treatment of tofacitinib. Among them 10.00% had upper respiratory tract infection (URTI), 6.67% had mild headache, 3.33% had nausea and 3.33% developed mild acne.
Conclusion: Tofacitinib, a JAK inhibitor, seems to be efficacious and safe in this trial. Tofacitinib's efficacy and safety in the treatment of vitiligo may require prospective clinical trials at numerous sites with a high sample size and a lengthy period of treatment with JAK inhibitors combined with or without light exposure/phototherapy.