Repigmentation in vitiligo using the janus kinase inhibitor, tofacitinib, may require concomitant light exposure
| Autor: | Brett A. King, Lucy Y. Liu, Maggi Ahmed Refat, James P. Strassner, John E. Harris |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Ruxolitinib medicine.medical_treatment Vitiligo Autoimmunity Skin Pigmentation Dermatology Chemokine CXCL9 Severity of Illness Index Article 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Depigmentation Piperidines medicine Humans Pyrroles skin and connective tissue diseases Protein Kinase Inhibitors Janus kinase inhibitor Aged Retrospective Studies Autoimmune disease Tofacitinib business.industry Janus Kinase 3 Immunosuppression Janus Kinase 1 Middle Aged medicine.disease Combined Modality Therapy Chemokine CXCL10 030104 developmental biology Pyrimidines Female Ultraviolet Therapy medicine.symptom business Janus kinase medicine.drug |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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