Low-dose tofacitinib with 308-nm excimer therapy successfully induced repigmentation in patients with refractory vitiligo

Fang, Wei-Cheng; Lin, Sheng-Yiao; Huang, Shu‐Mei; Lan, Cheng‐Che E.

doi:10.1111/ced.15070

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…A case of restarting oral tofacitinib with a lower dose after discontinuation for 1 month maintained the JAKi response 20 . Authors suggested that high doses achieve suppression of immunity and low doses promote melanocyte regeneration 22 and help avoid unwanted systemic adverse effects 23 . Nevertheless, for treatment‐refractory vitiligo, a higher dose or longer duration of treatment may be needed 24 …”

Section: Discussionmentioning

confidence: 99%

“…20 Authors suggested that high doses achieve suppression of immunity and low doses promote melanocyte regeneration 22 and help avoid unwanted systemic adverse effects. 23 Nevertheless, for treatment-refractory vitiligo, a higher dose or longer duration of treatment may be needed. 24 Topical tofacitinib was tried in adolescents for bilateral upper eyelid vitiligo associated with eyelash leukotrichia, 25 refractory acrofacial vitiligo, 26 and chin and neck lesions in combination with phototherapy, 27 with favorable results.…”

Section: Lesion Location and Repigmentation Responsementioning

confidence: 99%

“…15,18,22,24 Oral tofacitinib, in combination with NBUVB, was also effective in treating those with refractory vitiligo with poor response to conventional therapies. 32 However, there are reports 18,23,24 of poor to no response on acral lesions despite achieving overall repigmentation while on oral tofacitinib and phototherapy.…”

Section: Combination Light Therapymentioning

confidence: 99%

See 2 more Smart Citations

Janus kinase inhibitors and the changing landscape of vitiligo management: a scoping review

Utama,

Wijesinghe,

Thng

2024

Int J Dermatology

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Vitiligo is a chronic skin condition caused by an autoimmune response that results in the progressive loss of melanocytes and recent studies have suggested that Janus kinase inhibitors (JAKi) are emerging as a promising new treatment modality. Therefore, to assess and understand the extent of knowledge in the emerging field of JAKi use in vitiligo, a scoping review of the literature was undertaken. The reviewed articles explored a wide variety of JAKi administered either orally or topically for vitiligo. There were no injectable JAKi studied. Tofacitinib was the most commonly studied oral JAKi in 16 of the 35 studies selected for review, followed by baricitinib (n = 3), and one study each with ritlecitinib, ruxolitinib, and upadacitinib. Ruxolitinib (n = 6) and tofacitinib (n = 6) were the most often studied topical JAKi, followed by delgocitinib (n = 1). Potential benefits may vary between JAKi based on their receptor selectivity profile and coexistent autoimmune diseases. A topical JAKi would be advantageous in limited body area involvement and in adolescents. Concurrent use of JAKi with phototherapy or sun exposure appears beneficial. Most studies permitted the use of other topical agents. Acne‐related events, though frequent yet mild, were reported with both oral and topical JAKi. Nasopharyngitis, upper respiratory tract infections, and headaches were the most common adverse effects seen in the larger trials with JAKi. No serious or clinically meaningful hematology or thromboembolic events were detected. Treatment of vitiligo with oral or topical JAKi seems to be promising and the growing evidence shows a favorable risk‐benefit profile.

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Section: Discussionmentioning

confidence: 99%

Section: Lesion Location and Repigmentation Responsementioning

confidence: 99%

See 1 more Smart Citation

Janus kinase inhibitors and the changing landscape of vitiligo management: a scoping review

Utama,

Wijesinghe,

Thng

2024

Int J Dermatology

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“…In contrast to these findings, Fang et al, in a study involving four patients, demonstrated that a combination of low-dose tofacitinib and NB-UVB therapy for 16 weeks proved inadequate for treating refractory vitiligo, with only one out of four patients exhibiting significant repigmentation [18]. Encouragingly, a subsequent study by the same researchers showed more promising results when treating three patients with low-dose tofacitinib in combination with 308 nm excimer light [19]. Furthermore, Komnitski and collaborators detailed a clinical case involving a 40-year-old female patient with rheumatoid arthritis and vitiligo who underwent treatment with tofacitinib at a dosage of 5 mg twice daily for two years, without exposure to ultraviolet light.…”

Section: Jak Inhibitors-tofacitinibmentioning

confidence: 97%

Updates on Potential Therapeutic Approaches for Vitiligo: Janus Kinase Inhibitors and Biologics

Pala,

Ribero,

Quaglino

et al. 2023

JCM

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Vitiligo, the most prevalent skin depigmenting disease, is characterized by the selective loss of melanocytes, impacting patients’ quality of life significantly. This autoimmune disorder progresses through a complex interplay of genetic and non-genetic factors, posing challenges in comprehending its pathogenesis and devising effective treatment strategies for achieving remission. Existing conventional therapeutic approaches, such as topical and oral corticosteroids, calcineurin inhibitors, and phototherapy, lack specificity, offer modest efficacy, and may entail potential adverse effects. Consequently, there is a pressing need for a more nuanced understanding of vitiligo’s pathogenesis to pave the way for targeted therapeutic innovations. This review aims to provide a comprehensive overview of recent developments and findings concerning Januse Kinase (JAK) inhibitors and biologics tested in vitiligo patients. JAK inhibitors have exhibited promising results, showcasing both efficacy and tolerability. In contrast, the outcomes of biologics treatment have been more varied. However, to establish a clearer understanding of which specific pathways to target for a more effective approach to vitiligo, additional in vitro studies and extensive clinical research involving a larger population are imperative.

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“…However, not all reports have yielded the same results. For instance, Fang et al [94], in a first study, observed a poor response to treatment with oral tofacitinib and phototherapy with narrow-band UVB in four patients, although in a second study, they did find an improvement after treatment with oral tofacitinib and phototherapy with a 308 nm excimer light [95].…”

Section: Case Reports and Case Seriesmentioning

confidence: 99%

Vitiligo: Pathogenesis and New and Emerging Treatments

Perez-Bootello,

Cova-Martin,

Naharro-Rodriguez

et al. 2023

IJMS

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Vitiligo is a complex disease with a multifactorial nature and a high impact on the quality of life of patients. Although there are multiple therapeutic alternatives, there is currently no fully effective treatment for this disease. In the current era, multiple drugs are being developed for the treatment of autoimmune diseases. This review assesses the available evidence on the pathogenesis of vitiligo, and a comprehensive review of treatments available for vitiligo now and in the near future is provided. This qualitative analysis spans 116 articles. We reviewed the mechanism of action, efficacy and safety data of phototherapy, afamelanotide, cyclosporine, phosphodiesterase 4 inhibitors, trichloroacetic acid, basic fibroblast growth factor, tumor necrosis factor (TNF) inhibitors, secukinumab, pseudocatalase and janus kinase (JAK) inhibitors. At the moment, there is no clearly outstanding option or fully satisfactory treatment for vitiligo, so it is necessary to keep up the development of new drugs as well as the publication of long-term effectiveness and safety data for existing treatments.

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Low-dose tofacitinib with 308-nm excimer therapy successfully induced repigmentation in patients with refractory vitiligo

Abstract: Combining low‐dose tofacitinib with 308‐nm excimer may be an effective treatment for patients with nonsegmental vitiligo who were refractory to conventional therapies.

Cited by 5 publications

References 5 publications

Janus kinase inhibitors and the changing landscape of vitiligo management: a scoping review

Janus kinase inhibitors and the changing landscape of vitiligo management: a scoping review

Updates on Potential Therapeutic Approaches for Vitiligo: Janus Kinase Inhibitors and Biologics

Vitiligo: Pathogenesis and New and Emerging Treatments

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