Efficacy and Safety Of Tofacitinib And Narrow-Band UVB In The Treatment Of Vitiligo

Abstract

Background: Vitiligo is a common acquired disorder of pigmentation which is often emotionally ruinous for patients. At present, only few satisfying treatments modalities are available. The efficacy of daily oral tofacitinib combined with twice weekly narrow-band UVB in the treatment of vitiligo remain less elucidated.

Objective: The study was conducted to see the safety and efficacy of combined treatment with oral tofacitinib and NB UVB in vitiligo.

Methods: The prospective clinical trial was conducted on 75 patients of vitiligo, attended at the department of dermatology and venereology, combined military hospital (CMH), Dhaka after taking a formal ethical clearance from the ethical committee of armed forces medical institute. Each individual patient was treated with one tablet tofacitinib (5 mg) taken orally once daily at morning and narrow band ultra violet B (NB UVB) phototherapy twice weekly for 4 months. Photograph of each lesion was taken at every visit. Efficacy (color change) and side effects were assessed at week 4, 8 and 16.

Results: Mean age of the subject was 36.43(±11.89) years with female predominance (M:F-0.70:1). Vitiligo was first present in lower limb (26.70%), face (18.70%), upper limb (13.30%), hand (13.30%), feet (12.0%), trunk (13.30%) and genital areas (2.7%). Of all, 35% cases had Fitzpatrick skin type IV, 42% cases had Fitzpatrick skin type V and 23% had Fitzpatrick skin type VI. Majority (62.70%) had excellent response, 28% had good response, 08% had moderate response and 1.30% had poor response. Common cold was the most (8%) common adverse effects followed by dryness, loss of appetite, yellow discoloration of eye, skin and urine and headache. Conclusion: Combined treatment of once daily oral tofacitinib and twice weekly NB UVB is excellent in two thirds of the cases of vitiligo with unremarkable side effects.

Keywords: Tofacitinib, Narrow band Ultraviolet B, Vitiligo.