Christopher White1,2, Richard Miller1,2. 1. Dr. White is with Dermatology Partners in Strongsville, Ohio. 2. Dr. Miller is with the Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine and the Largo Medical Center, in Largo, Florida.
Abstract
Background: Vitiligo is a disfiguring disease that frustrates both patients and clinicians due to its difficulty to treat. Topical Janus kinase inhibitors (TJKI) may offer an alternative treatment option that are safe and well-tolerated for all anatomic sites. Objective: The objective of this review was to evaluate the published clinical reports regarding the use of TJKI for the treatment of vitiligo and to summarize the formulations, dosing strategies, efficacy, and safety of this emerging therapeutic class. Methods: This is a review of the National Library of Medicine (via PubMed) and Scopus through April 2021. Results: The initial search revealed 45 potential articles; eight articles comprising 201 total patients met our inclusion criteria. Our analysis indicates that TJKI offer a viable therapeutic alternative, with similar efficacy to topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI). The beneficial effects of TJKI are most pronounced on facial skin and when combined with narrow-band ultraviolet B (NB-UVB) therapy. Limitations: Many publications reporting the use of TJKI have small sample sizes and do not use standardized scoring systems to evaluate disease extent and treatment response. Conclusion: Vitiligo remains a difficult disease to treat, and TJKI are an appealing new treatment option. While the aggregate data on the topic remain sparse, we offer a synthesized review of the literature to date and a glimpse into the ongoing investigations regarding this emerging drug class.
Background: Vitiligo is a disfiguring disease that frustrates both patients and clinicians due to its difficulty to treat. Topical Janus kinase inhibitors (TJKI) may offer an alternative treatment option that are safe and well-tolerated for all anatomic sites. Objective: The objective of this review was to evaluate the published clinical reports regarding the use of TJKI for the treatment of vitiligo and to summarize the formulations, dosing strategies, efficacy, and safety of this emerging therapeutic class. Methods: This is a review of the National Library of Medicine (via PubMed) and Scopus through April 2021. Results: The initial search revealed 45 potential articles; eight articles comprising 201 total patients met our inclusion criteria. Our analysis indicates that TJKI offer a viable therapeutic alternative, with similar efficacy to topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI). The beneficial effects of TJKI are most pronounced on facial skin and when combined with narrow-band ultraviolet B (NB-UVB) therapy. Limitations: Many publications reporting the use of TJKI have small sample sizes and do not use standardized scoring systems to evaluate disease extent and treatment response. Conclusion: Vitiligo remains a difficult disease to treat, and TJKI are an appealing new treatment option. While the aggregate data on the topic remain sparse, we offer a synthesized review of the literature to date and a glimpse into the ongoing investigations regarding this emerging drug class.
Authors: John E Harris; Mehdi Rashighi; Nhan Nguyen; Ali Jabbari; Grace Ulerio; Raphael Clynes; Angela M Christiano; Julian Mackay-Wiggan Journal: J Am Acad Dermatol Date: 2015-12-11 Impact factor: 11.527
Authors: Mehdi Rashighi; Priti Agarwal; Jillian M Richmond; Tajie H Harris; Karen Dresser; Ming-Wan Su; Youwen Zhou; April Deng; Christopher A Hunter; Andrew D Luster; John E Harris Journal: Sci Transl Med Date: 2014-02-12 Impact factor: 17.956
Authors: David Rosmarin; Amit G Pandya; Mark Lebwohl; Pearl Grimes; Iltefat Hamzavi; Alice B Gottlieb; Kathleen Butler; Fiona Kuo; Kang Sun; Tao Ji; Michael D Howell; John E Harris Journal: Lancet Date: 2020-07-11 Impact factor: 79.321
Authors: Ji Hae Lee; Hyuck Sun Kwon; Han Mi Jung; Hyunyong Lee; Gyong Moon Kim; Hyeon Woo Yim; Jung Min Bae Journal: JAMA Dermatol Date: 2019-08-01 Impact factor: 10.282