Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of Tofacitinib in the Treatment of Psoriatic Arthritis: A Systematic Review

  • Review
  • Published:
Advances in Therapy Aims and scope Submit manuscript

Abstract

Introduction

Therapeutic approaches for psoriatic arthritis (PsA) include non-pharmacologic therapies, symptomatic treatments, tumor necrosis factor inhibitors, interleukin inhibitors, cytotoxic T lymphocyte antigen 4 immunoglobulin, and Janus kinase inhibitors. This systematic review aimed to provide complete and up-to-date information on efficacy of tofacitinib in the treatment of PsA, giving special attention to non-skin manifestations (peripheral arthritis, axial disease, enthesitis, and dactylitis).

Methods

A search of studies published between January 2016 and June 2020 was carried out on PubMed and Google Scholar.

Results

The number of studies with tofacitinib in PsA is limited and most of them are post hoc analyses from OPAL Broaden and OPAL Beyond. Tofacitinib has been demonstrated to be efficacious for the treatment of all disease manifestations in PsA. Superior effectivity to placebo is achieved at the earliest time point evaluated, and maintained over time. Patients who switch from placebo to tofacitinib show the same improvements; however, the time to initial response is faster in patients who firstly receive tofacitinib, compared with those switching subsequently. Additional data suggest that tofacitinib may be also effective for the treatment of the axial domain.

Conclusions

Tofacitinib has been demonstrated to be efficacious for the treatment of peripheral and axial involvement, enthesitis, and dactylitis manifestation in PsA. Further prospective and long-term studies are required to corroborate and complete the present results. Similarly, real-world evidence is also necessary to complement the information obtained in clinical trials, and thereby to have a better overview of real efficacy and safety of the drug.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gladman DD, Antoni C, Mease P, Clegg D, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis. 2005;64(2):14–7.

    Google Scholar 

  2. Mease PJ. Psoriatic arthritis: update on pathophysiology, assessment and management. Ann Rheum Dis. 2011;70(1):77–84.

    Article  Google Scholar 

  3. Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med. 2017;376(21):957–70.

    Article  PubMed  Google Scholar 

  4. Haddad A, Zisman D. Comorbidities in patients with psoriatic arthritis. Rambam Maimonides Med J. 2017;8(1):e0004.

    Article  PubMed Central  Google Scholar 

  5. Gudu T, Gossec L. Quality of life in psoriatic arthritis. Expert Rev Clin Immunol. 2018;14(5):405–17.

    Article  CAS  PubMed  Google Scholar 

  6. Gladman DD. Axial disease in psoriatic arthritis. Curr Rheumatol Rep. 2007;9(6):455–60.

    Article  PubMed  Google Scholar 

  7. Feld J, Chandran V, Haroon N, et al. Axial disease in psoriatic arthritis and ankylosing spondylitis: a critical comparison. Nat Rev Rheumatol. 2018;14(6):363–71.

    Article  PubMed  Google Scholar 

  8. Acosta Felquer ML, Oliver FO. Peripheral joint involvement in psoriatic arthritis patients. Clin Exp Rheumatol. 2015;33(93):26–30.

    Google Scholar 

  9. Torre Alonso JC, Rodriguez Perez A, Arribas Castrillo JM, Ballina Garcia J, Riestra Noriega JL, Lopez LC. Psoriatic arthritis (PA): a clinical, immunological and radiological study of 180 patients. Br J Rheumatol. 1991;30(4):245–50.

    Article  CAS  PubMed  Google Scholar 

  10. Álvarez Castro C, Zapico Fernández I. Artritis psoriásica: manifestaciones clínicas, diagnóstico, pronóstico. In: Sanmartí Sala R, director. Espondiloartritis. Monografías SER no. 2. Madrid: Médica Panamericana; 2004, p. 219–30.

  11. Lubrano E. Axial disease. In: FitzGerald O, Gladman D, editors. Oxford textbook of psoriatic arthritis. Oxford: Oxford University Press; 2018.

    Google Scholar 

  12. Caso F, Navarini L, Ruscitti P, et al. Targeted synthetic pharmacotherapy for psoriatic arthritis: state of the art. Expert Opin Pharmacother. 2020;21(7):785–96.

    Article  CAS  PubMed  Google Scholar 

  13. Singh JA, Guyatt G, Ogdie A, et al. Special article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the treatment of psoriatic arthritis. Arthritis Care Res (Hoboken). 2019a;71(1):2–29.

    Article  Google Scholar 

  14. Berekmeri A, Mahmood F, Wittmann M, Helliwell P. Tofacitinib for the treatment of psoriasis and psoriatic arthritis. Expert Rev Clin Immunol. 2018;14(9):719–30.

    Article  CAS  PubMed  Google Scholar 

  15. European Medicines Agency. Summary of opinion (post authorisation). Xeljanz tofacitinib. http://www.ema.europa.eu/docs/en_GB/document_library/Summary_of_opinion/human/004214/WC500247974.pdf. Accessed 17 Oct 2020.

  16. European Medicines Agency. XELJANZ (Tofacitinib). Summary of product characteristics. https://www.ema.europa.eu/en/documents/product-information/xeljanz-epar-product-information_en.pdf. Accessed 17 Oct 2020.

  17. Mease P, Hall S, FitzGerald O, et al. Tofacitinib or adalimumab versus placebo for psoriatic arthritis. N Engl J Med. 2017;377(16):1537–50.

    Article  CAS  PubMed  Google Scholar 

  18. Gladman D, Rigby W, Azevedo VF, et al. Tofacitinib for psoriatic arthritis in patients with an inadequate response to TNF inhibitors. N Engl J Med. 2017;377(16):1525–36.

    Article  CAS  PubMed  Google Scholar 

  19. Eriksen MB, Frandsen TF. The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. J Med Libr Assoc. 2018;106(4):420–31.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62(10):1006–12.

    Article  PubMed  Google Scholar 

  21. Asahina A, Etoh T, Igarashi A, et al. Oral tofacitinib efficacy, safety and tolerability in Japanese patients with moderate to severe plaque psoriasis and psoriatic arthritis: a randomized, double-blind, phase 3 study. J Dermatol. 2016;43(8):869–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Strand V, de Vlam K, Covarrubias-Cobos JA, et al. Effect of tofacitinib on patient-reported outcomes in patients with active psoriatic arthritis: results from two phase 3 studies. Ann Rheum Dis. 2017;76:1335–6.

    Article  CAS  Google Scholar 

  23. Bachelez H, Griffiths CEM, Papp K, et al. Effect of tofacitinib on efficacy and patient-reported outcomes in psoriasis patients with baseline psoriatic arthritis: a pooled analysis of 2 phase 3 studies. Arthritis Rheumatol. 2017;69.

  24. van der Heijde D, Deodhar A, Wei JC, et al. Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study. Ann Rheum Dis. 2017;76(8):1340–7.

    Article  PubMed  CAS  Google Scholar 

  25. Ungprasert P, Erwin PJ, Koster MJ. Indirect comparisons of the efficacy of biological agents in patients with active ankylosing spondylitis: a systematic review and meta-analysis. Clin Rheumatol. 2017;36(7):1569–77.

    Article  PubMed  Google Scholar 

  26. Behrens F, Gomez-Reino J, Nash P, et al. Impact of baseline demographics, disease activity and concomitant medication on American College of Rheumatology 20 response rate and Health Assessment Questionnaire-Disability Index Score with tofacitinib in active psoriatic arthritis: a pooled subgroup analysis of 2 phase 3 studies. Ann Rheum Dis. 2018;77:1585–6.

    Article  Google Scholar 

  27. Kivitz AJ, FitzGerald O, Nash P, et al. Efficacy of tofacitinib by background methotrexate dose in patients with psoriatic arthritis: a post-hoc analysis of pooled data from 2 phase 3 trials. Ann Rheum Dis. 2018;77:1575.

    Google Scholar 

  28. Burmester G, Rigby WFC, Choy E, et al. Changes in lymphocytes and lymphocyte subsets in tofacitinib-treated patients with psoriatic arthritis. Ann Rheum Dis. 2018;77:1030.

    Article  Google Scholar 

  29. Maksymowych WP, van der Heijde D, Baraliakos X, et al. Tofacitinib is associated with attainment of the minimally important reduction in axial magnetic resonance imaging inflammation in ankylosing spondylitis patients. Rheumatology (Oxford). 2018;57(8):1390–9.

    Article  CAS  Google Scholar 

  30. Helliwell P, Coates LC, FitzGerald O, et al. Disease-specific composite measures for psoriatic arthritis are highly responsive to a Janus kinase inhibitor treatment that targets multiple domains of disease. Arthritis Res Ther. 2018;20(1):242.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  31. Nash P, Coates LC, Fleischmann R, et al. Efficacy of tofacitinib for the treatment of psoriatic arthritis: pooled analysis of two phase 3 studies. Rheumatol Ther. 2018;5(2):567–82.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Ritchlin C, Giles J, Ogdie A, et al. Tofacitinib in patients with psoriatic arthritis and metabolic syndrome: a post-hoc analysis of phase 3 studies. Ann Rheum Dis. 2018;77:1023.

    Google Scholar 

  33. Gladman DD, Orbai AM, Gomez-Reino J, et al. Network meta-analysis of tofacitinib vs bdmards or apremilast for the treatment of TNF inhibitor-naÏve patients with psoriatic arthritis. Ann Rheum Dis. 2018;77:368–9.

    Google Scholar 

  34. Ogdie A, de Vlam K, Bushmakin AG, et al. Baseline pain severity as a predictor of pain improvement following treatment with tofacitinib in psoriatic arthritis. Ann Rheum Dis. 2019;78:1852–3.

    Google Scholar 

  35. Nash P, Coates L, Mease PJ, et al. Tofacitinib as monotherapy following methotrexate withdrawal in patients with psoriatic arthritis previously treated with open-label tofacitinib + methotrexate: a randomized, placebo-controlled sub-study of OPAL Balance. Arthritis Rheumatol. 2019;71(Suppl.10): 5250–5253. https://doi.org/10.1002/art.41108.

    Article  Google Scholar 

  36. Gladman D, Coates L, Wu J, et al. Time to response for clinical and patient-reported outcomes in patients with psoriatic arthritis treated with tofacitinib, adalimumab, or placebo. Arthritis Rheumatol. 2019;71(Suppl. 10):697–9. https://doi.org/10.1002/art.41108.

    Article  Google Scholar 

  37. Ritchlin C, Ogdie A, Giles J, et al. Impact of baseline body mass index on the efficacy and safety of tofacitinib in patients with psoriatic arthritis. Arthritis Rheumatol. 2019;71(Suppl. 10):2675–7. https://doi.org/10.1002/art.41108.

    Article  Google Scholar 

  38. Nash P, Greenwald M, Lin LH, et al. The impact of time since first diagnosis on the efficacy and safety of tofacitinib in patients with active psoriatic arthritis. Arthritis Rheumatol. 2019;71(Suppl. 10):2605–8. https://doi.org/10.1002/art.41108.

    Article  Google Scholar 

  39. Citera G, Schneeberger E, Nash P, et al. Comparison of different remission indices in patients with psoriatic arthritis: a post hoc analysis of data from phase 3 tofacitinib studies. Arthritis Rheumatol. 2019;71(Suppl. 10):2585–8. https://doi.org/10.1002/art.4110.

    Article  Google Scholar 

  40. Pham PA, Dressler C, Eisert L, Nast A, Werner RN. Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals. Rheumatol Int. 2019;39(4):605–18.

    Article  CAS  PubMed  Google Scholar 

  41. Strand V, de Vlam K, Covarrubias-Cobos JA, et al. Tofacitinib or adalimumab versus placebo: patient-reported outcomes from OPAL Broaden-a phase III study of active psoriatic arthritis in patients with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs. RMD Open. 2019a;5(1):e000806.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Strand V, de Vlam K, Covarrubias-Cobos JA, et al. Effect of tofacitinib on patient-reported outcomes in patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors in the phase III, randomised controlled trial: OPAL Beyond. RMD Open. 2019b;5(1):e000808.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Song GG, Lee YH. Comparison of the efficacy and safety of tofacitinib and apremilast in patients with active psoriatic arthritis: a Bayesian network meta-analysis of randomized controlled trials. Clin Drug Investig. 2019;39(5):421–8.

    Article  PubMed  Google Scholar 

  44. van der Heijde D, Gladman DD, FitzGerald O, et al. Radiographic progression according to baseline C-reactive protein levels and other risk factors in psoriatic arthritis treated with tofacitinib or adalimumab. J Rheumatol. 2019;46(9):1089–96.

    Article  PubMed  CAS  Google Scholar 

  45. Lu C, Wallace BI, Waljee AK, Fu W, Zhang Q, Liu Y. Comparative efficacy and safety of targeted DMARDs for active psoriatic arthritis during induction therapy: a systematic review and network meta-analysis. Semin Arthritis Rheum. 2019;49(3):381–8.

    Article  CAS  PubMed  Google Scholar 

  46. Rigby W, Burmester GR, Fitzgerald O, et al. Changes in key laboratory values with tofacitinib 5 mg bid treatment in patients with psoriatic arthritis and rheumatoid arthritis. Ann Rheum Dis. 2019;78:1682–3.

    Google Scholar 

  47. Deodhar A, Chakravarty SD, Cameron C, et al. A systematic review and network meta-analysis of current and investigational treatments for active ankylosing spondylitis. Clin Rheumatol. 2020;39(8):2307–15.

  48. Ogdie A, de Vlam K, McInnes IB, et al. Efficacy of tofacitinib in reducing pain in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis. RMD Open. 2020;6:e001042.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Galindez E, Prieto-Peña D, Martín-Varillas JL, et al. Treatment with tofacitinib in refractory psoriatic arthritis. Multicenter study of 87 patients in clinical practice. Ann Rheum Dis. 2020;79:1682.

    Article  Google Scholar 

  50. Dougados M, van der Heijde D, Bingham C, et al. The effect of tofacitinib on residual pain in patients with psoriatic arthritis. Ann Rheum Dis. 2020;79:760–1.

    Article  PubMed  Google Scholar 

  51. Nash P, Coates LC, Kivitz AJ, et al. Safety and efficacy of tofacitinib in patients with active psoriatic arthritis: interim analysis of OPAL Balance, an open-label, long-term extension study. Rheumatol Ther. 2020;7(3):553–80.

  52. Merola JF, Papp KA, Nash P, et al. Tofacitinib in psoriatic arthritis patients: skin signs and symptoms and health-related quality of life from two randomized phase 3 studies. J Eur Acad Dermatol Venereol. 2020. https://doi.org/10.1111/jdv.16433Citations:1.

  53. Korotaeva T, Vorobyova L, Loginova E, et al. Tofacitinib improves disease activity and patient-reported outcomes (PROS) in patients (PTS) with active psoriatic arthritis (PSA) in real clinical practice. Ann Rheum Dis. 2020;79:1729.

    Google Scholar 

  54. Chamurlieva M, Loginova E, Gubar E, Korsakova Y, Glukhova S, Korotaeva T. The contribution of joint symptoms, enthesitis, skin and nail psoriasis (PSO) to minimal disease activity (MDA) achievement in psoriatic arthritis (PSA) patients (PTS). Effect of tofacitinib treatment. Data from real clinical practice. Ann Rheum Dis. 2020;79:1669.

    Article  Google Scholar 

  55. Gubar E, Korotaeva T, Korsakova Y, Loginova E, Karpova P. Effect of tofacitinib treatment on active MRI sacroiliitis and disease activity reduction in psoriatic arthritis patients. Data from clinical practice. Ann Rheum Dis. 2020;79:1162.

    Google Scholar 

  56. Loginova E, Korotaeva T, Gubar E, et al. Comparative effectiveness of tofacitinib (TF) and adalimumab (ADA) in psoriatic arthritis (PSA) patients in real clinical practice. Ann Rheum Dis. 2020;79:1168.

    Article  Google Scholar 

  57. Gubar E, Korotaeva T, Korsakova Y, Loginova E, Glukhova S, Karpova P. Association of active MRI sacroiliitis with dactylitis and work productivity impairment in psoriatic arthritis patients. Positive effects of tofacitinib treatment. Data from clinical practice. Ann Rheum Dis. 2020;79:1162–73.

    Google Scholar 

  58. Tucker LJ, Coates LC, Helliwell PS. Assessing disease activity in psoriatic arthritis: a literature review. Rheumatol Ther. 2019;6(1):23–32.

    Article  PubMed  Google Scholar 

  59. Mease PJ, Woolley JM, Bitman B, Wang BC, Globe DR, Singh A. Minimally important difference of Health Assessment Questionnaire in psoriatic arthritis: relating thresholds of improvement in functional ability to patient-rated importance and satisfaction. J Rheumatol. 2011;38(11):2461–5.

    Article  PubMed  Google Scholar 

  60. Mease PJ, Palmer JB, Liu M, et al. Influence of axial involvement on clinical characteristics of psoriatic arthritis: analysis from the Corona Psoriatic Arthritis/Spondyloarthritis Registry. J Rheumatol. 2018;45(10):1389–96.

    Article  PubMed  Google Scholar 

  61. Singh JA, Guyatt G, Ogdie A, et al. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the treatment of psoriatic arthritis. Arthritis Rheumatol. 2019b;71(1):5–32.

    Article  PubMed  Google Scholar 

  62. Ogdie A, Coates LC, Gladman DD. Treatment guidelines in psoriatic arthritis. Rheumatology (Oxford). 2020;59(1):37–46.

    Article  Google Scholar 

  63. Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020;79(6):700–12.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Funding

Pfizer S.L.U. has unconditionally financed the execution of this project, including the journal’s Rapid Service fee.

Medical Writing, Editorial and Other Assistance

We would like to thank Susan Ramirez and Noelia Llevat for their work looking over this paper. The authors also express their gratitude to Meisys, for helping with the manuscript writing.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Francisco José Rebollo Laserna and Susana Gómez Castro work for Pfizer S.L.U. Jordi Gratacós Masmitjà and Carlos M. González Fernández have nothing to declare.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Data Availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

Author information

Authors and Affiliations

  1. Rheumatology Department, Hospital Universitari Parc Taulí Sabadell, Medicine Department UAB, Barcelona, Spain

    Jordi Gratacós Masmitjà

  2. CEIMI, Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Carlos M. González Fernández

  3. Sanitary Research Institute Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain

    Carlos M. González Fernández

  4. Pfizer Medical Department, Alcobendas, Madrid, Spain

    Susana Gómez Castro & Francisco José Rebollo Laserna

Authors
  1. Jordi Gratacós Masmitjà
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlos M. González Fernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Susana Gómez Castro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francisco José Rebollo Laserna
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carlos M. González Fernández.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gratacós Masmitjà, J., González Fernández, C.M., Gómez Castro, S. et al. Efficacy of Tofacitinib in the Treatment of Psoriatic Arthritis: A Systematic Review. Adv Ther 38, 868–884 (2021). https://doi.org/10.1007/s12325-020-01585-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12325-020-01585-7

Keywords

Search

Navigation