Psoriatic arthritis

Tofacitinib improves dermatologic symptoms and QoL in PsA

The JAK inhibitor tofacitinib (Xeljanz) provides improvement in patient-reported dermatologic symptoms and quality of life sustained for up to a year in patients with psoriatic arthritis, a new study shows.

An analysis of patient reported dermatologic endpoints from two PsA studies – OPAL Broaden and OPAL Beyond  – found that tofacitinib was more effective than placebo at three months, with the benefits on painful, inflamed, or broken skin being maintained at six and twelve months.

The results are derived from the previously published studies that involved patients with active PsA and inadequate response to conventional synthetic DMARDs who were TNF inhibitors-naïve (OPAL Broaden, n= 422) or an inadequate response to a TNF inhibitor (OPAL Beyond, n= 394).

The studies previously showed that tofacitinib [and adalimumab] had greater efficacy than placebo against rheumatic manifestations of PsA as measured by ACR20, and also against the dermatological manifestations as measured by Psoriasis Area and Severity Index 75% improvement (PASI75) scores for tofacitinib BID 10mg at three months.

The new data show that tofacitinib was more effective than placebo across a range of dermatologic outcomes, including PASI75 and PASI90, at three months, regardless of baseline severity. Tofacitinib was also significantly more effective than placebo when measured by PASI90 overall scores, and patients also reported significantly greater improvements in dermatological manifestations as measured by PGA-PsO and Health Related Quality of Life (HrQoL) scores, as well as improvements in itch  and HRQoL associated with itchy and painful skin up to three months.

Furthermore, the improvements in dermatologic symptoms were sustained up to 12 months in the OPAL Broaden study and six months  in OPAL Beyond.

Similar effects on dermatologic endpoints compared to placebo were seen in adalimumab-treated patients in the OPAL Broaden study, but the trial was not statistically powered to allow comparisons with tofacitinib, the study authors said.

They said the additional findings for dermatologic manifestations were important, given that many patients with PsA often reported that painful, inflamed and broken skin were more bothersome symptoms, than joint pain, soreness or tenderness.

“These data confirm that tofacitinib provides a treatment option for patients with active PsA including burdensome dermatologic symptoms,” they concluded.

The study is published in the Journal of the European Academy of Dermatology and Venereology and was sponsored by Pfizer, makers of tofacitinib.

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