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Tofacitinib for the treatment of psoriasis and psoriatic arthritis

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Berekmeri A1, Mahmood F2, Wittmann M3, Helliwell P4. Expert Rev Clin Immunol. 2018 Aug 17. doi: 10.1080/1744666X.2018.1512404. [Epub ahead of print]

Abstract

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1 a Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit (LMBRU), Chapel Allerton Hospital , Leeds , LS7 4SA.

2 b Rheumatology , Bradford Teaching Hospitals , Little Horton Lane, Bradford , West Yorkshire , BID5 0NA.

3 c Inflammatory Skin Diseases , Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit (LMBRU), Chapel Allerton Hospital , Leeds , LS7 4SA.

4 d Rheumatology , Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital , Harehills Lane, Leeds , LS7 4SA.

Abstract

Psoriasis and psoriatic arthritis (PsA) are inflammatory immune mediated conditions which can cause considerable disability and reduced quality of life. Management can be complex as clinical heterogeneity may lead to different treatment pathways. Tofacitinib is a novel, oral janus kinase (JAK) inhibitor with proven efficacy in rheumatoid arthritis. Areas covered: This review analyses recent studies of tofacitinib in psoriatic disease treatment. The relevant literature was identified using clinicaltrials.gov, PubMed and Google Scholar. Tofacitinib efficacy was demonstrated in PsA by the OPAL Broaden and OPAL Beyond phase III studies, and received FDA and EMA approval. Tofacitinib was superior to placebo for the treatment of moderate to severe plaque psoriasis in the OPT Pivotal 1 and 2, OPT Retreatment studies, but FDA approval was declined for this indication based on issues of clinical efficacy and long-term safety. Expert Commentary: Tofacitinib is an important oral drug for the treatment of PsA. However, the long-term safety data requires further evaluation. Tofacitinib and other JAK inhibitors show potential to broaden the treatment options in PsA and other inflammatory conditions.