Greater Tofacitinib Persistence in Patients With Psoriatic Arthritis, Enthesitis

According to a retrospective study in The Journal of Rheumatology, patients with psoriatic arthritis (PsA) who have enthesitis are more likely to persist on treatment with the Janus kinase (JAK) inhibitor tofacitinib.

The study was a longitudinal, observational study of all patients with PsA at a single center who received at least 1 dose of tofacitinib. “Information on the persistence of tofacitinib in PsA is scarce in real-life conditions,” the authors wrote. “Our objective was to analyze persistence and safety of tofacitinib under these conditions.”

The primary end points were adverse events (AEs) and drug survival. Seventy-two patients were included, of whom 54 were women. The mean age was 51.9 ± 11.1 years.

The mean disease duration was 10.40 ± 6.99 years. For more than 70% of patients, tofacitinib was the third or higher line of therapy they received. Median treatment survival was 13 months (interquartile range [IQR], 5.3-29.0). The 1-year retention rate on tofacitinib was 52.7% (95% CI, 42.4-65.6).

Sex, disease duration, comorbidities, or line of treatment were not associated with tofacitinib survival. Younger patients were less likely to discontinue tofacitinib compared with older patients (hazard ratio [HR], 0.96; P<.05). Patients with enthesitis were also less likely to discontinue treatment (HR, 0.37; P<0.05).

Regarding AEs, the overall rate was 52.9 events per 100 person-years (95% CI, 38.5-70.6). Most AEs occurred during the first 6 months of tofacitinib exposure.

In this real-life study, tofacitinib showed a reasonably good retention rate in a PsA population mostly refractory to biologic and oral targeted-synthetic [disease-modifying antirheumatic drugs],” the authors summarized. “Patients with refractory PsA and enthesitis might be a specific target population for this drug. No new alarm signals emerged.”