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Pain response in patients with psoriatic arthritis treated with Tofacitinib

Pain is a core domain of psoriatic arthritis ( PsA ). A post hoc analysis has evaluated time to pain improvement and the impact of baseline pain severity on pain response in patients with psoriatic arthritis receiving Tofacitinib ( Xeljanz ).

Data from two trials ( NCT01877668; NCT01882439 ) in patients receiving Tofacitinib 5mg twice daily, placebo switching to Tofacitinib 5mg twice daily at month 3 ( placebo-to-Tofacitinib ) or Adalimumab ( Humira ) ( NCT01877668 only ) were included.

Improvement in pain ( 30% or more / 50% or more decrease from baseline in Visual Analogue Scale [ VAS ] pain score ) was assessed; median time to initial ( first post-baseline visit ) / continued ( first two consecutive postbaseline visits ) pain improvement was estimated ( KaplanMeier ) for all treatment arms.

At month 3, more patients have experienced pain improvements with Tofacitinib / Adalimumab versus placebo.

Median days to initial / continued pain improvements of 30% or more and 50% or more, respectively, were 55 / 60 and 85 / 171 for Tofacitinib, versus 106 / 126 and 169 / NE ( not-estimable ) for placebo-to-Tofacitinib.

Pain improvements were also experienced more quickly for Adalimumab versus placebo.

Predicted time to 30% or more / 50% or more pain improvement was shorter in patients with higher baseline pain versus lower baseline pain ( Tofacitinib arm only ).

In conclusion, in patients with psoriatic arthritis, pain improvements were experienced by more patients, and more rapidly, with Tofacitinib and Adalimumab versus placebo.
In those receiving Tofacitinib, higher baseline pain was associated with faster pain improvements. ( Xagena )

de Vlam K et al, RMD Open 2021;7:e001609. doi:10.1