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BMC Dermatol. 2016 Oct 3;16(1):15.

Treatment of plaque psoriasis with an ointment formulation of the Janus kinase inhibitor, tofacitinib: a Phase 2b randomized clinical trial.

Author information

1
K Papp Clinical Research and Probity Medical Research Inc, Waterloo, ON, Canada.
2
Innovaderm Research, Montreal, QC, Canada.
3
SKiN Centre for Dermatology and Probity Medical Research Inc, Peterborough, and Queens University, Kingston, ON, Canada.
4
Wake Forest Baptist Health, Winston-Salem, NC, USA.
5
Aarhus University Hospital, Aarhus, Denmark.
6
Southern California Dermatology, Santa Ana, CA, USA.
7
Dermatology Consulting Services, High Point, NC, USA.
8
Pfizer Worldwide Biopharmaceuticals, Global Innovative Pharma Business, Groton, CT, USA.
9
Pfizer Worldwide Biopharmaceuticals, Global Innovative Pharma Business, Groton, CT, USA. william.c.ports@pfizer.com.

Abstract

BACKGROUND:

Most psoriasis patients have mild to moderate disease, commonly treated topically. Current topical agents have limited efficacy and undesirable side effects associated with long-term use. Tofacitinib is a small molecule Janus kinase inhibitor investigated for the topical treatment of psoriasis.

METHODS:

This was a 12-week, randomized, double-blind, parallel-group, vehicle-controlled Phase 2b study of tofacitinib ointment (2 % and 1 %) applied once (QD) or twice (BID) daily in adults with mild to moderate plaque psoriasis. Primary endpoint: proportion of patients with Calculated Physician's Global Assessment (PGA-C) clear or almost clear and ≥2 grade improvement from baseline at Weeks 8 and 12. Secondary endpoints: proportion of patients with PGA-C clear or almost clear; proportion achieving Psoriasis Area and Severity Index 75 (PASI75) response; percent change from baseline in PASI and body surface area; change from baseline in Itch Severity Item (ISI). Adverse events (AEs) were monitored and clinical laboratory parameters measured.

RESULTS:

Overall, 435 patients were randomized and 430 patients received treatment. The proportion of patients with PGA-C clear or almost clear and ≥2 grade improvement from baseline at Week 8 was 18.6 % for 2 % tofacitinib QD (80 % confidence interval [CI] for difference from vehicle: 3.8, 18.2 %) and 22.5 % for 2 % tofacitinib BID (80 % CI: 3.1, 18.5 %); this was significantly higher vs vehicle for both dosage regimens. No significant difference vs vehicle was seen at Week 12. Significantly more patients achieved PGA-C clear or almost clear with 2 % tofacitinib QD and BID and 1 % tofacitinib QD (not BID) at Week 8, and with 2 % tofacitinib BID at Week 12. Pruritus was significantly reduced vs vehicle with 2 % and 1 % tofacitinib BID (starting Day 2), and 2 % tofacitinib QD (starting Day 3). Overall, 44.2 % of patients experienced AEs, 8.1 % experienced application site AEs, and 2.3 % experienced serious AEs. The highest incidence of AEs (including application site AEs) was in the vehicle QD group.

CONCLUSIONS:

In adults with mild to moderate plaque psoriasis, 2 % tofacitinib ointment QD and BID showed greater efficacy than vehicle at Week 8, but not Week 12, with an acceptable safety and local tolerability profile.

TRIAL REGISTRATION:

NCT01831466 registered March 28, 2013.

KEYWORDS:

CP-690,550; Dermatology Life Quality Index; Itch; PASI; Physician’s Global Assessment; Pruritus; Psoriasis; Psoriasis Area and Severity Index; Tofacitinib; Topical

PMID:
27716172
PMCID:
PMC5048458
DOI:
10.1186/s12895-016-0051-4
[Indexed for MEDLINE]
Free PMC Article

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