Tofacitinib as a Promising Therapeutic Option for Vitiligo: A Systematic Review.

BACKGROUND: Vitiligo is a chronic autoimmune disease characterized by depigmented patches on the skin. Despite the availability of several therapeutic options, treatment outcomes remain variable, particularly in extensive or refractory disease. Tofacitinib, a Janus kinase (JAK) inhibitor, has emerged as a potential therapeutic option for vitiligo. Here we aimed to review the existing evidence on the efficacy and safety of tofacitinib for the treatment of vitiligo. METHODS: A comprehensive search was conducted in PubMed, Scopus, and Web of Science identify English-language studies evaluating the use of tofacitinib in vitiligo patients. RESULTS: Twenty-five studies evaluating oral and topical tofacitinib were reviewed. Reported repigmentation rates ranged from 14.4% to 90%, with several studies also demonstrating improvements in disease activity scores. Most adverse events were mild and infrequent. However, the available evidence is derived predominantly from case reports, case series, and small observational studies, and many patients received concomitant therapies such as phototherapy, limiting the interpretation of treatment efficacy. CONCLUSION: Current evidence suggests that tofacitinib may represent a promising therapeutic option for vitiligo. However, the available evidence remains limited by the predominance of small uncontrolled studies, heterogeneous treatment protocols, and concomitant therapies. Larger prospective controlled studies are needed to better establish its efficacy, long-term safety, and role within current vitiligo treatment strategies.