Repigmentation in vitiligo using the Janus kinase inhibitor tofacitinib may require concomitant light exposure.
J Am Acad Dermatol
; 77(4): 675-682.e1, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-28823882
ABSTRACT
BACKGROUND:
Vitiligo is an autoimmune disease in which cutaneous depigmentation occurs. Existing therapies are often inadequate. Prior reports have shown benefit of the Janus kinase (JAK) inhibitors.OBJECTIVE:
To evaluate the efficacy of the JAK 1/3 inhibitor tofacitinib in the treatment of vitiligo.METHOD:
This is a retrospective case series of 10 consecutive patients with vitiligo treated with tofacitinib. Severity of disease was assessed by body surface area of depigmentation.RESULTS:
Ten consecutive patients were treated with tofacitinib. Five patients achieved some repigmentation at sites of either sunlight exposure or low-dose narrowband ultraviolet B phototherapy. Suction blister sampling revealed that the autoimmune response was inhibited during treatment in both responding and nonresponding lesions, suggesting that light rather than immunosuppression was primarily required for melanocyte regeneration.LIMITATIONS:
Limitations include the small size of the study population, retrospective nature of the study, and lack of a control group.CONCLUSION:
Treatment of vitiligo with JAK inhibitors appears to require light exposure. In contrast to treatment with phototherapy alone, repigmentation during treatment with JAK inhibitors may require only low-level light. Maintenance of repigmentation may be achieved with JAK inhibitor monotherapy. These results support a model wherein JAK inhibitors suppress T cell mediators of vitiligo and light exposure is necessary for stimulation of melanocyte regeneration.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Piperidinas
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Pirimidinas
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Pirróis
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Terapia Ultravioleta
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Vitiligo
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Pigmentação da Pele
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Inibidores de Proteínas Quinases
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article