Vitiligo is not a life-threatening disease, but it causes significant psychological
distress for patients which often enduring stigmatization and social isolation and being
more subject to psychiatric morbidities. Narrowband ultraviolet B phototherapy and
tofacitinib are the effective treatment options for vitiligo now a days. However, other existing
therapies for vitiligo often yield suboptimal results and have some associated side effects.
To compare the adverse effects of tofacitinib with narrowband ultraviolet B
Phototherapy in the treatment of vitiligo.
This study was a prospective randomized clinical trial, conducted
in the Outpatient Department of Dermatology and Venereology at Bangabandhu Sheikh
Mujib Medical University (BSMMU), Dhaka, Bangladesh. The duration of study was from
March 2021 to August 2022. Each adult vitiligo patient attending the Dermatology and
Venereology Outpatient department was randomly allocated to either group A or group B.
Group A total 53 Patients were treated with tofacitinib 5mg twice daily for 6 months. Group
B 53 Patients were treated with narrowband ultraviolet B phototherapy twice weekly. Patients
of both groups were followed up for six months. Efficacy was measured by VASI score and at
each visit patients were observed for any adverse reaction.
This study showed that the mean age was 30.5±12.0 yearsin group Aand 32.8±10.5
years in group B respectively. The difference between the two groups in terms of age was not
statistically significant (p=0.303). The mean change in VASI score in group B (2.19±0.61) was
lower compared to mean change of VASI score in group A (3.79±1.26). The difference of change
in VASI score between the two groups was statistically significant (p<0.001).The most common
type of adverse effect was upper respiratory tract infection (11.32%), followed by acne (5.66%)
in group A. The common type of adverse effect of phototherapy was symptomatic erythema
(16.9%), xerosis with pruritus (15.9%) and hyperpigmentation over vitiligo patch (9.43%). The
study showed that in group B out of 53 participants, 26 developed mild adverse effects and 2
developed serious adverse effects. On the other hand, in Group A, out of 53 participants, 18
developed mild adverse effects but no one developed any serious adverse effects.
On the basis of these results, tofacitinib is safer than narrowband ultraviolet
B Phototherapy in the treatment of vitiligo. Multicenter study with longer treatment period
and follow-up should be carried out in future.
safety of tofacitinib, safety of narrowband ultraviolet B Phototherapy, treatment
of vitiligo.
