Efficacy and safety of tofacitinib for moderate‐to‐severe plaque psoriasis: a systematic review and meta‐analysis of randomized controlled trials

Kuo, Chi-Mei; Tung, Tao‐Hsin; Wang, S.-H.; Chi, C.‐C.

doi:10.1111/jdv.14695

Cited by 29 publications

(22 citation statements)

References 37 publications

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“…Both drugs have been approved for PsA since then . Tofacitinib is not included within the oral small molecules (OSM) category since its benefit/risk profile differs from that of the rest of the OSMs, especially with regard to risks , and consistent with its being considered separately in other treatment guidelines . Additionally, the panel addressed alternatives in patient subpopulations (e.g., patients with predominant enthesitis, axial disease, dactylitis, comorbidities), and greater versus lesser disease severity.…”

Section: Methodsmentioning

confidence: 99%

2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

Singh

Guyatt

Ogdie

et al. 2018

Arthritis Care & Research

322

202

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Objective. To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF).Methods. We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/ outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations.Results. The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment.Conclusion. The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA. Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intendedto provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be voluntary, with the ultimate determination regarding their application to be made by the health care provider in light of each patient's individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice. ACR recommendations are not intended to dictate payment or insurance decisions. These recommendations cannot adequately convey all uncertainties and nuances of patient care.The American College of Rheumatology...

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Section: Methodsmentioning

confidence: 99%

2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

Singh

Guyatt

Ogdie

et al. 2018

Arthritis Care & Research

322

202

View full text Add to dashboard Cite

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“…Tofacitinib 10 mg was found to be non-inferior to etanercept, but tofacitinib 5 mg was not shown to be non-inferior to etanercept. 32 Although study results demonstrated that both the 5 mg and 10 mg doses were effective in treating plaque psoriasis, [33][34][35] the 10 mg dose was proven to be more efficacious. 36 However, this higher dose is associated with increased safety concerns, leading the FDA to decline approval of tofacitinib for moderate-to-severe plaque psoriasis.…”

Section: Psoriasis Clinical Trialsmentioning

confidence: 99%

<p>Tofacitinib in the management of active psoriatic arthritis: patient selection and perspectives</p>

Ly¹,

Beck²,

Smith³

et al. 2019

PTT

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Tofacitinib is an oral Janus kinase inhibitor approved for the treatment of psoriatic arthritis (PsA). It provides an alternative option for patients who have had an inadequate response and tolerance to other disease modifying antirheumatic drugs (DMARDs). It has demonstrated comparable efficacy to biologics, is effective in the management of treatment resistant disease, and is reported to improve enthesitis, dactylitis, and radiographic progression. Tofacitinib is also associated with an increased risk of serious infections, malignancy, and laboratory abnormalities. There is currently a large armamentarium of therapies for psoriatic arthritis, and choosing among treatments can be challenging. Due to this wide selection, a thorough assessment of psoriatic disease phenotype, patient preference, disease presentation, and comorbidities is critical. This review addresses key considerations in patient selection for the treatment of PsA with tofacitinib.

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“…Treatment with IFN-α, an important cytokine in the pathogenesis of both vitiligo and psoriasis, for HCV and HBV infection can induce both psoriasis and vitiligo [ 129 , 130 , 131 ]. Moreover, narrow band ultraviolet B phototherapy and Janus kinase inhibitor can be used for treating both psoriasis and vitiligo [ 132 , 133 , 134 ].…”

Section: The Risk Of Autoimmune Diseases In Psoriasis and Psoriatimentioning

confidence: 99%

The Risk of Systemic Diseases in Those with Psoriasis and Psoriatic Arthritis: From Mechanisms to Clinic

Woo

Park

Kang

et al. 2020

IJMS

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Psoriasis and psoriatic arthritis (PsA) have been recently considered as chronic systemic inflammatory disorders. Over the past decades, enormous evidence indicates that patients with psoriasis and PsA have a higher risk of developing various comorbidities including cardiovascular disease, metabolic disease, cancers, infections, autoimmune disease, and psychiatric diseases. However, reported risks of some comorbidities in those with psoriasis and PsA are somewhat different according to the research design. Moreover, pathomechanisms underlying comorbidities of those with psoriasis and PsA remain poorly elucidated. The purpose of this review is to provide the most updated comprehensive view of the risk of systemic comorbidities in those with psoriasis and PsA. Molecular mechanisms associated with the development of various comorbidities in those with psoriasis and PsA are also reviewed based on recent laboratory and clinical investigations. Identifying the risk of systemic comorbidities and its associated pathomechanisms in those with psoriasis and PsA could provide a sufficient basis to use a multi-disciplinary approach for treating patients with psoriasis and PsA.

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Efficacy and safety of tofacitinib for moderate‐to‐severe plaque psoriasis: a systematic review and meta‐analysis of randomized controlled trials

Cited by 29 publications

References 37 publications

2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

<p>Tofacitinib in the management of active psoriatic arthritis: patient selection and perspectives</p>

The Risk of Systemic Diseases in Those with Psoriasis and Psoriatic Arthritis: From Mechanisms to Clinic

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