Comparison of Efficacy of Oral Tofacitinib (JAK Inhibitor) Combined with Narrow Band UVB Vs Alone Oral Tofacitinib in Patient with Vitiligo at Tertiary Care Hospital, Karachi
DOI:
https://doi.org/10.70749/ijbr.v2i02.427Keywords:
Vitiligo, Combined Therapy, VASI, Long-Term EfficacyAbstract
Objective: compare the oral Tofacitinib added to NB-UVB phototherapy versus Tofacitinib monotherapy in patients with vitiligo, at a tertiary care teaching hospital in Karachi. Methods: After the ethical approval from the institutional review board, this open-label, non-randomized study is conducted at the Department of Dermatology, JPMC, Karachi from April 2024 to Sep 2024. Through non-probability consecutive sampling, 40 patients aged 18 above, both genders, diagnosed of vitiligo with stable lesions for half a year were included in the present study. The patients were divided into groups: Group B patients that received only oral Tofacitinib 5 mg twice a day (n=20) and Group A patients treated with oral Tofacitinib 5 mg twice a day in combination with NB-UVB phototherapy three time weekly (n=20). Results: At 12 weeks, the VASI score showed significant improvement in the Tofacitinib + NB-UVB group (36.8 ± 8.3) compared to the Tofacitinib alone group (54.15 ± 9.5, p < 0.0001). The percentage improvement in VASI was also significantly higher in the combination therapy group at 57.4 ± 9.7% versus 36.7 ± 9.9% in the monotherapy group (p < 0.0001). Furthermore, the efficacy outcome, defined as ≥51% improvement in re-pigmentation, was achieved in 15 patients (75%) in the Tofacitinib + NB-UVB group compared to only 1 patient (5%) in the Tofacitinib alone group, with a highly significant p-value of <0.0001. Conclusion: Oral tofacitinib complemented with NB-UVB phototherapy is more effective than Tofacitinib monotherapy in re-pigmentation in vitiligo patients.
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References
Thawabteh, A. M., Jibreen, A., Karaman, D., Thawabteh, A., & Karaman, R. (2023). Skin pigmentation types, causes and treatment—A review. Molecules, 28(12), 4839. https://doi.org/10.3390/molecules28124839
Gandhi, K., Ezzedine, K., Anastassopoulos, K. P., Patel, R., Sikirica, V., Daniel, S. R., Napatalung, L., Yamaguchi, Y., Baik, R., & Pandya, A. G. (2022). Prevalence of vitiligo among adults in the United States. JAMA Dermatology, 158(1), 43. https://doi.org/10.1001/jamadermatol.2021.4724
Salama, A. H., Alnemr, L., Khan, A. R., Alfakeer, H., Aleem, Z., & Ali-Alkhateeb, M. (2023). Unveiling the unseen struggles: A comprehensive review of vitiligo's psychological, social, and quality of life impacts. Cureus. https://doi.org/10.7759/cureus.45030
Qi, F., Liu, F., & Gao, L. (2021). Janus kinase inhibitors in the treatment of vitiligo: A review. Frontiers in Immunology, 12. https://doi.org/10.3389/fimmu.2021.790125
Inoue, S., Suzuki, T., Sano, S., & Katayama, I. (2024). JAK inhibitors for the treatment of vitiligo. Journal of Dermatological Science, 113(3), 86-92. https://doi.org/10.1016/j.jdermsci.2023.12.008
Feng, Y., & Lu, Y. (2022). Advances in vitiligo: Update on therapeutic targets. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.986918
Barbulescu, C. C., Goldstein, N. B., Roop, D. R., Norris, D. A., & Birlea, S. A. (2020). Harnessing the power of regenerative therapy for vitiligo and alopecia Areata. Journal of Investigative Dermatology, 140(1), 29-37. https://doi.org/10.1016/j.jid.2019.03.1142
Song, H., Hu, Z., Zhang, S., Yang, L., Liu, Y., & Wang, T. (2022). Effectiveness and safety of tofacitinib combined with narrowband ultraviolet B phototherapy for patients with refractory vitiligo in real‐world clinical practice. Dermatologic Therapy, 35(11). https://doi.org/10.1111/dth.15821
Pala, V., Ribero, S., Quaglino, P., & Mastorino, L. (2023). Updates on potential therapeutic approaches for vitiligo: Janus kinase inhibitors and biologics. Journal of Clinical Medicine, 12(23), 7486. https://doi.org/10.3390/jcm12237486
Liu, L. Y., Strassner, J. P., Refat, M. A., Harris, J. E., & King, B. A. (2017). Repigmentation in vitiligo using the Janus kinase inhibitor tofacitinib may require concomitant light exposure. Journal of the American Academy of Dermatology, 77(4), 675-682.e1. https://doi.org/10.1016/j.jaad.2017.05.043
Wang, X., Wu, W., Chen, J., Li, C., & Li, S. (2024). Management of the refractory vitiligo patient: Current therapeutic strategies and future options. Frontiers in Immunology, 14. https://doi.org/10.3389/fimmu.2023.1294919
Zhu, B., Liu, C., Zhang, L., Wang, J., Chen, M., & Wei, Y. (2022). Comparison of NB-UVB combination therapy regimens for vitiligo: A systematic review and network meta-analysis. Journal of Cosmetic Dermatology, 22(3), 1083-1098. https://doi.org/10.1111/jocd.15534
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