Tofacitinib shows promise in managing psoriatic arthritis, finds study

Pain is a core domain of psoriatic arthritis (PsA). Tofacitinib is an oral Janus kinase (JAK) inhibitor for the treatment of PsA. The efficacy and safety of tofacitinib in PsA have been demonstrated in phase 3 trials of up to 12 months' duration in patients with an inadequate response to conventional synthetic DMARDs (OPAL Broaden; NCT0187766825) or tumour necrosis factor inhibitor (TNFi) therapy. This recent post hoc analysis evaluated time to pain improvement and the impact of baseline pain severity on pain response in patients with PsA receiving tofacitinib.

For the study design, data from two trials with patients receiving tofacitinib 5 mg twice daily, placebo switching to tofacitinib 5 mg twice daily at month 3 (placebo-to-tofacitinib) or adalimumab were included. Improvement in pain (≥30%/≥50% decrease from baseline in Visual Analogue Scale pain score) was assessed; median time to initial (first post-baseline visit)/continued (first two consecutive post-baseline visits) pain improvement was estimated (Kaplan-Meier) for all treatment arms. A parametric model was used to determine the relationship between baseline pain severity and time to pain response in patients receiving tofacitinib.

Results highlighted some interesting facts.

• At month 3, more patients experienced pain improvements with tofacitinib/adalimumab versus placebo.
• Median days (95% CI) to initial/continued pain improvements of ≥30% and ≥50%, respectively, were 55 (29–57)/60 (57–85) and 85 (57–92)/171 (90–not estimable (NE)) for tofacitinib, versus 106 (64–115)/126 (113–173) and 169 (120–189)/NE (247–NE) for placebo-to-tofacitinib.
• Pain improvements were also experienced more quickly for adalimumab versus placebo.
• Predicted time to ≥30%/≥50% pain improvement was shorter in patients with higher baseline pain versus lower baseline pain (tofacitinib arm only).

"The findings from the current analysis could guide physicians in their management of patient expectations with respect to pain reduction and, in particular, when patients with PsA may expect to notice meaningful improvements with tofacitinib. Because the VAS is widely used as a means of measuring pain, its utilisation in this study may help translate these findings to clinical practice."the team concluded.

For full article follow : de Vlam K, Ogdie A, Bushmakin AG, et alMedian time to pain improvement and the impact of baseline pain severity on pain response in patients with psoriatic arthritis treated with tofacitinibRMD Open 2021;7:e001609. doi: 10.1136/rmdopen-2021-001609

Source: Psoriatic Arthritis