Role of topical tofacitinib in autoimmune skin disorders: An expert opinion

Abstract

Autoimmune skin diseases, caused by immune system dysfunctions, have complex mechanisms. Biologicals are widely used to treat these chronic conditions. These available treatments for autoimmune skin diseases have several drawbacks, including related adverse effects, issues with adherence to long-term therapy, and the need for better management strategies. Recently, JAK inhibitors, like tofacitinib, have shown promise in treating vitiligo, alopecia areata (AA), atopic dermatitis (AD), and psoriasis, among other autoimmune dermatological conditions. Conventional systemic therapies require monitoring for adverse events (AEs) and risk of drug interactions, thus resulting in reduced compliance. Topical JAK inhibitors have a superior safety profile due to low systemic absorption, provide tailored therapy, and limited systemic effects. Topical tofacitinib is being investigated for off-label autoimmune dermatological disorders and has shown promising outcomes. According to the opinion of the experts, topical tofacitinib (2%), twice daily (BID), is suggested as an effective treatment for autoimmune skin diseases with minimal AEs.