A twice-daily 2% tofacitinib cream in addition to narrow-band ultraviolet B (NBUVB) administration has shown promise for improving the symptoms of facial vitiligo, according to the results of a small pilot study published in the Journal of the American Academy of Dermatology.
Patients with vitiligo of the face were recruited from the Pigmentary Disorders Clinic at The University of Texas Southwestern Medical Center (n=11, mean age, 44 years). Only patients who had not received benefit with topical corticosteroids or calcineurin-inhibitors in addition to thrice weekly NBUVB phototherapy or sunlight exposure were enrolled in the study. Treatment consisted of twice-daily 2% tofacitinib cream in addition to thrice-weekly NBUVB over a period of approximately 3 months. At 3-month follow-up, the researchers measured the amount of depigmentation in each participant with the facial Vitiligo Area Severity Index.
The mean time to follow-up was 112 (range, 84 to 154) days. There was a 70% (range, 50% to 87%) mean improvement in the facial Vitiligo Area Severity Index from baseline to 3-month follow-up (0.8 [range, 0.1 to 2.25] vs 0.23 [range, 0.03 to 0.75], respectively). The 30-g tube of tofacitinib costs $320, but because of its small application area, the medication lasted each patient an average of 90 days. No adverse effects were reported.
Study limitations included its small sample size, its use on only the face, and the lack of control groups.
“Future controlled studies with larger sample sizes and long-term follow up should be performed,” the researchers wrote. “If they are confirmatory, topical tofacitinib may become a useful addition to our therapeutic armamentarium for vitiligo.”
McKesey J, Pandya AG. A pilot study of 2% tofacitinib cream with narrow-band UVB for the treatment of facial vitiligo [published online April 19, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.04.032.