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 Detalle_Publicacion

Treatment With Tofacitinib in Refractory Psoriatic Arthritis: A National Multicenter Study of the First 87 Patients in Clinical Practice

Abstract: Objective: Tofacitinib (TOF) is the first Janus kinase (JAK) inhibitor approved for psoriatic arthritis (PsA). It has shown efficacy in patients refractory to anti-tumor necrosis factor-? in randomized controlled trials (RCTs). Our aim was to assess efficacy and safety of TOF in clinical practice. Methods: This was an observational, open-label multicenter study of PsA patients treated with TOF due to inefficacy or adverse events of previous therapies. Outcome variables were efficacy, corticosteroid dose-sparing effect, retention rate, and safety. A comparative study of clinical features between our cohort of patients and those from the OPAL Beyond trial was performed. Results: There were 87 patients (28 women/59 men), with a mean age of 52.8 ± 11.4 years. All patients were refractory to biologic disease-modifying antirheumatic drugs (DMARDs) and/or to conventional synthetic DMARDs plus apremilast. TOF was started at 5 mg twice daily after a mean follow-up of 12.3 ± 9.3 years from PsA diagnosis. At first month, Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) decreased from median 4.8 (IQR 4.1-5.4) to 3.7 (IQR 2.8-4.7, P < 0.01), Disease Activity Index for Psoriatic Arthritis from median 28 (IQR 18.4-34.1) to 15.5 (IQR 10.1-25.7, P < 0.01), and C-reactive protein from median 1.9 (IQR 0.3-5.0) to 0.5 (IQR 0.1-2.2) mg/dL (P < 0.01). Also, TOF led to a significant reduction in prednisone dose. Mild adverse effects were reported in 21 patients (24.13%), mainly gastrointestinal symptoms. TOF retention rate at Month 6 was 77% (95% CI 65.2-86.3). Patients in clinical practice were older with longer disease duration and received biologic agents more commonly than those in the OPAL Beyond trial. Conclusion: Data from clinical practice confirm that TOF seems to be effective, rapid, and relatively safe in refractory PsA despite clinical differences with patients in RCTs.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: J Rheumatol . 2021 Oct;48(10):1552-1558

Editorial: The Journal of Rheumatology Publishing Company Limited

 Año de publicación: 2021

Nº de páginas: 7

Tipo de publicación: Artículo de Revista

 DOI: 10.3899/jrheum.201204

ISSN: 0315-162X

Url de la publicación: https://www.doi.org/10.3899/jrheum.201204

Autores/as

GALÍNDEZ-AGIRREGOIKOA, EVA

DIANA PRIETO PEÑA

MARTÍN-VARILLAS, JOSÉ LUIS

JOVEN, BEATRIZ

RUSINOVICH, OLGA

MELERO-GONZÁLEZ, RAFAEL B

ORTIZ-SANJUAN, FRANCISCO

ALMODÓVAR, RAQUEL

ALEGRE-SANCHO, JUAN JOSÉ

MARTÍNEZ, ÁNGELS

SELLAS-FERNÁNDEZ, AGUSTÍ

MÉNDEZ, LARA

GARCÍA-VICUÑA, ROSARIO

BELÉN ATIENZA MATEO

RICARDO BLANCO ALONSO