A Literature Review Investigating the Use of Topical Janus Kinase Inhibitors for the Treatment of Vitiligo.

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.