This is one of two trials reported in the New England Journal of Medicine suggesting the short term efficacy of this orally administered Janus kinase (JAK) inhibitor for the treatment of psoriatic arthritis.
According to an editorial, the Arthritis Advisory Committee of the FDA recently recommended the approval of tofacitinib for the treatment of psoriatic arthritis, with the caution that a lower rate of progression (as assessed radiographically) has not been shown. It notes that comparisons of tofacitinib with other biologic DMARDs will inform its place in the treatment algorithm of psoriatic arthritis and differences in safety will also inform the choice of treatments. It adds that although all biologic DMARDs and tofacitinib are broadly immunosuppressive, tofacitinib appears to carry an additional risk of herpes zoster infection. Furthermore, alterations in serum lipid levels also occur with tofacitinib, the long-term clinical consequences of which are still unclear. It suggests that tofacitinib may find a place alongside TNF inhibitors and phosphodiesterase-4 inhibitors in treatment algorithms, noting that although more head-to-head comparisons will be useful, other factors, such as cost, convenience, safety, and the extent of skin disease, will be considerations in treating patients and improving outcomes.
Currently tofacitinib is only licensed the treatment of moderate to severe active rheumatoid arthritis in adult patients who have responded inadequately to, or who are intolerant to one or more disease-modifying antirheumatic drugs.