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

Abstract

The effects of tofacitinib in treating moderate-to-severe plaque psoriasis were unclear. We aimed to assess the effects of tofacitinib in treating moderate-to-severe plaque psoriasis. We searched PubMed, Cochrane Central Register of Controlled Trials and EMBASE for relevant randomized controlled trials (RCTs) and conducted a systematic review and meta-analysis. Four RCTs with 2724 participants were included. Compared to placebo, tofacitinib significantly improved psoriasis {≥75% reduction in the Psoriasis Area and Severity Index score: 5 mg BID: risk difference (RD) 0.32 [95% confidence interval (CI) 0.28-0.35], 10 mg BID: RD 0.51 (95% CI 0.43-0.58); ≥90% reduction in the Psoriasis Area and Severity Index score: 5 mg BID: RD 0.19 (95% CI 0.17-0.22), 10 mg BID: RD 0.36 (95% CI 0.31-0.42); Physician's Global Assessment 0/1: 5 mg BID: RD 0.31 (95% CI 0.27-0.35), 10 mg BID: RD 0.48 (95% CI 0.44-0.53)} and participants' life quality [Dermatology Life Quality Index 0/1: 5 mg BID: RD 0.24 (95% CI 0.20-0.2), 10 mg BID: RD 0.36 (95% CI 0.33-0.40)]. Tofacitinib was associated with an increase in minor adverse events [upper respiratory tract infection: 5 mg BID: RD 0.02 (95% CI 0.00-0.03), 10 mg BID: RD 0.02 (95% CI 0.00-0.04); hypercholesterolaemia: 5 mg BID: RD 0.02 (95% CI 0.01-0.04), 10 mg BID: RD 0.02 (95% CI 0.01-0.04)]. In conclusion, tofacitinib may be a treatment option for moderate-to-severe plaque psoriasis that is unresponsive to other therapies and patients who are intolerable to other therapies or prefer oral medications.

• Authors: C-M Kuo, T-H Tung, S-H Wang, C-C Chi
• Journal: Journal of the European Academy of Dermatology and Venereology : JEADV (J Eur Acad Dermatol Venereol) Vol. 32 Issue 3 Pg. 355-362 (Mar 2018) ISSN: 1468-3083 [Electronic] England
• PMID: 29136293 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: © 2017 European Academy of Dermatology and Venereology.

Chemical References

• Dermatologic Agents
• Janus Kinase Inhibitors
• Piperidines
• Placebos
• Pyrimidines
• Pyrroles
• tofacitinib

Topics

• Dermatologic Agents (administration & dosage, adverse effects, therapeutic use)
• Humans
• Janus Kinase Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Piperidines (administration & dosage, adverse effects, therapeutic use)
• Placebos
• Psoriasis (drug therapy, physiopathology)
• Pyrimidines (administration & dosage, adverse effects, therapeutic use)
• Pyrroles (administration & dosage, adverse effects, therapeutic use)
• Quality of Life
• Randomized Controlled Trials as Topic
• Severity of Illness Index
• Treatment Outcome