Efficacy and Safety of Tofacitinib for Vitiligo: A Systematic Review

Riyad Mustafa Abuhalimeh; Basel H. Bakhamees; Alhanouf Wakid H Alharthi; Raghad Awadh Alharbi; Omar Abdulaziz M Alsuwailem; Waleed Khalid Z Alghuyaythat; Atheer Nasser A  Alzahrani; Ghena Mahir Abdulrahman Alsaadi; Lama Mohammed Albelowi; Nada Mutep Hakem Almijlad

doi:10.54293/smhj.v5i1.128

Authors

Riyad Mustafa Abuhalimeh Consultant Dermatology, M.O.H -North Medical Tower, Arar, KSA.
Basel H. Bakhamees Faculty of Medicine, King Abdulaziz University, Jeddah, KSA. https://orcid.org/0009-0009-1501-6885
Alhanouf Wakid H Alharthi Medical student, ⁠Bisha University, ⁠Bisha, ⁠KSA.
Raghad Awadh Alharbi MBBS, Almaarefa University, Riyadh, KSA.
Omar Abdulaziz M Alsuwailem Medical intern, King Faisal University, Alahsa, KSA.
Waleed Khalid Z Alghuyaythat College of Medicine, Majmaah University, Majmaah, KSA.
Atheer Nasser A Alzahrani Medical intern, Al-Baha University, Al-Baha, KSA. https://orcid.org/0009-0004-6595-4443
Ghena Mahir Abdulrahman Alsaadi Intern, KAUH, Jeddah, KSA. https://orcid.org/0009-0002-0413-4914
Lama Mohammed Albelowi Medical intern, Taibah university, Almadinah Almunawarrah, KSA.
Nada Mutep Hakem Almijlad Intern, Dermatology Department, Northern Border University, Arar, KSA.

DOI:

https://doi.org/10.54293/smhj.v5i1.128

Keywords:

Tofacitinib; JAK inhibitors; Vitiligo; Immune-mediated skin disorders; Systematic review.

Abstract

The main objective of this study was to evaluate and summarize the available clinical evidence on the efficacy and safety of tofacitinib for the treatment of vitiligo. A thorough search across four databases identified 416 relevant publications. After removing duplicates using Rayyan QCRI and assessing their relevance, 204 full-text articles were reviewed, and ultimately, five studies met the criteria for inclusion were included. A total of 121 vitiligo patients were included; less than half of them 52 (43%) were males. Findings indicate that while tofacitinib alone has limited effectiveness, its combination with narrowband-ultraviolet B (NBUVB) phototherapy significantly enhances repigmentation, particularly in refractory cases, including acral lesions. Micro-focused UVB phototherapy also demonstrates high efficacy, with further improvements observed when paired with tofacitinib. However, a 16-week treatment duration may be insufficient for patients with inadequate responses to prior therapies, suggesting the need for higher doses or extended treatment periods. This makes a combination of tofacitinib and phototherapy promising as a therapeutic strategy against vitiligo, with cases resistant to all the modalities of standard therapy. As promising as these results read with significant repigmentation, full optimization of treatment duration and dosage will be imperative. These findings need to be further confirmed in future large, randomized controlled trials and long-term outcomes evaluated to definitely establish a standardized protocol for vitiligo management. These efforts will be essential to fully realize the potential of Janus kinase (JAK) inhibitors as part of a comprehensive, targeted approach to the management of vitiligo.