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Br J Dermatol. 2015 Oct;173(4):949-61. doi: 10.1111/bjd.14018.

Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: results from two randomized, placebo-controlled, phase III trials.

Collaborators (140)

Rosoph LA, Kunynetz RA, Lynde CW, Sapra S, Rober MR, Gilbert M, Wiseman MC, Tomi ZS, Carey WD, Albrecht L, Toth D, Barber K, Wasel N, Guenther LC, Loranger L, Tuppal RK, Amiss J, Woolner DB, Gooderham MJ, Gulliver WP, Adam DN, Castellanos H, Raad JJ, Arredondo MI, Mrowietz U, Wildfeur T, Philipp S, Wilsmann-Theis D, Dirschka T, Wozel G, Thron A, Theis E, Jasnoch V, Pres H, Hoffmann M, Ockenfels HM, Sebastian M, Wohlrab J, Streit V, Augustin mM, Bayerl C, Frambach Y, Zuechner D, Nagy Z, Orojan I, Battyani Z, Kovago L, Telegdy E, Bajor KM, Nishigori C, Yasuda M, Ihn H, Horie K, Torii H, Gonzalez-Soto RF, Villanueva-Quintero DG, Amaya-Guerra M, Toledo-Bahena ME, Baran W, Pawlaczyk M, Maleszka R, Weglowska J, Owczarek W, Padlewska K, Kaszuba A, Cruz AM, Majcan P, Zecevic R, Tsai TF, Sheu HM, Lee WR, Ho JC, Yang CH, Wei CC, Prytulo OO, Kutasevych Y, Khara OI, Stepanenko VI, Radionov VG, Muzhychuk VV, Nadashkevich ON, Lebediuk MM, Tyring SK, Tu JH, Dawes KW, Shupack JL, Nunis JB, Mark LA, Baker DR, Gillum PS, Soung J, Hamilton TK, Maloney JM 3rd, Behringer FR Jr, Weisman JD, Baskin M, Ling MR, Ferris LK, Frankel EH, Henderson CD, Savin RC, Primka EJ 3rd, Cather JC, Nasir A, Sharata HH, Schlessinger J, Yamauchi PS, Vasiloudes P, Kimball AB, Genebriera-Delamo J, Rich P, Leonardi CL, Pariser DM, Getz P, Pelle MT, Stough DB, Hudson CP, Hata TR, Bruce S, Carrasco D, Lee MS, Hurley MY, Beasley RL, Cohen DJ, Moore AY, Abramovits W, Ehst B, Chapman MS, Adams DR, Murakawa GJ, Krueger JG, Lugo-Somolinos A, Fang ML, Singri P, Mehlis S, Hamzavi FH, Crowley JJ, Sofen HL, Hassman DR, Lee PC.

Author information

1
Probity Medical Research and K Papp Clinical Research Inc., 135 Union Street East, Waterloo, ON, N2J 1C4, Canada.
2
Baylor Research Institute, Dallas, TX, U.S.A.
3
Gunma University Hospital, Maebashi, Gunma, Japan.
4
University of Alabama, Tuscaloosa, AL, U.S.A.
5
Wake Forest Baptist Health, Winston-Salem, NC, U.S.A.
6
Tufts Medical Center, Boston, MA, U.S.A.
7
Dalhousie University, Halifax, NS, Canada.
8
University of Münster, Münster, Germany.
9
University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
10
Pfizer Inc., Groton, CT, U.S.A.

Abstract

BACKGROUND:

Tofacitinib is an oral Janus kinase inhibitor being investigated for psoriasis.

OBJECTIVES:

To determine the 16-week efficacy and safety of two oral tofacitinib doses vs. placebo in patients with moderate-to-severe chronic plaque psoriasis.

METHODS:

Patients in two similarly designed phase III studies (OPT Pivotal 1, NCT01276639, n = 901; OPT Pivotal 2, NCT01309737, n = 960) were initially randomized 2 : 2 : 1 to tofacitinib 10 or 5 mg or placebo, twice daily. Coprimary efficacy end points (week 16) included the proportion of patients achieving Physician's Global Assessment (PGA) of 'clear' or 'almost clear' (PGA response) and the proportion achieving ≥ 75% reduction in Psoriasis Area and Severity Index (PASI 75).

RESULTS:

Across OPT Pivotal 1 and OPT Pivotal 2, 745 patients received tofacitinib 5 mg, 741 received tofacitinib 10 mg and 373 received placebo. At week 16, a greater proportion of patients achieved PGA responses with tofacitinib 5 and 10 mg twice daily vs. placebo (OPT Pivotal 1, 41·9% and 59·2% vs. 9·0%; OPT Pivotal 2, 46·0% and 59·1% vs. 10·9%; all P < 0·001). Higher PASI 75 rates were observed with tofacitinib vs. placebo (OPT Pivotal 1, 39·9%, 59·2% and 6·2%, respectively, for tofacitinib 5 and 10 mg twice daily and placebo; OPT Pivotal 2, 46·0%, 59·6% and 11·4%; all P < 0·001 vs. placebo). Adverse event (AE) rates appeared generally similar across groups; rates of serious AEs, infections, malignancies and discontinuations due to AEs were low. Twelve patients reported herpes zoster across the tofacitinib treatment groups in both studies vs. none in the respective placebo groups. The most common AE across groups was nasopharyngitis.

CONCLUSIONS:

Oral tofacitinib demonstrated significant efficacy vs. placebo during the initial 16 weeks of treatment in patients with moderate-to-severe psoriasis. Safety findings were consistent with prior studies.

PMID:
26149717
DOI:
10.1111/bjd.14018
[Indexed for MEDLINE]

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