Comparison between Tab Tofacitinib and Low-Dose Oral Steroid in Patients Having Vitiligo Over 6 Months

Abstract

Background: Vitiligo is a chronic autoimmune condition characterized by depigmented patches on the skin, presenting significant treatment challenges. Recent studies have focused on the immunomodulatory effects of tofacitinib, a Janus kinase inhibitor, and the anti-inflammatory properties of low-dose oral steroids, yet comparative data on their efficacy and safety are scarce. Objective: The aim of this study was to compare the efficacy and safety of tofacitinib tablets with low-dose oral steroids in the treatment of vitiligo over a six-month period. Methods: This descriptive comparative study involved 42 patients with vitiligo, recruited from the Department of Dermatology at the Combined Military Hospital Abbottabad between November 15, 2022, and November 15, 2023. Participants were randomly assigned to receive either tofacitinib tablets (Group A) or low-dose oral steroids (Group B), with adherence monitored through routine follow-ups. The primary outcome measured was the proportion of repigmentation, assessed using standardized photography and Image software, alongside lesion size reduction and the incidence of adverse events. Statistical analyses were performed using SPSS version 25, with p-values ≤0.05 considered significant. Results: Both groups demonstrated comparable efficacy in terms of repigmentation and lesion size reduction, with no significant difference observed between the tofacitinib (55.8% ± 15.2 repigmentation; 100% lesion size reduction) and low-dose steroid groups (50.2% ± 13.5 repigmentation; 85.71% lesion size reduction) at the 6-month follow-up. The incidence of adverse events was similarly low and statistically non-significant between the two groups. Conclusion: Tofacitinib and low-dose oral steroids are both effective and safe for the treatment of vitiligo, offering valuable options for patient management. Further research with larger sample sizes and longer follow-up is necessary to confirm these findings and evaluate the long-term outcomes of these treatments.