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Oral Janus kinase inhibitors: efficacy of Tofacitinib on clinical signs of moderate-to-severe plaque psoriasis in different body regions


Tofacitinib ( Xeljanz ) is a novel, oral Janus kinase inhibitor currently under investigation for plaque psoriasis.

This exploratory analysis of a phase IIb, 12-week, dose-ranging study has evaluated Tofacitinib efficacy in four body regions of patients with moderate-to-severe chronic plaque psoriasis.

Patients ( n=197 ) were randomized to Tofacitinib 2, 5, or 15 mg, or placebo, twice daily ( BID ).

Psoriasis Area and Severity Index ( PASI ) score, body surface area values and change from baseline to week 12 were measured according to body region ( head/neck, upper limbs, trunk and lower limbs ).
Change in Target Plaque Severity Score ( TPSS ) from baseline to week 12 was measured according to typically responsive as well as non-responsive treatment areas.

At week 12, mean improvements in PASI and body surface area values were significantly greater with Tofacitinib doses versus placebo across all four body regions measured ( P less than 0.0001 ).

TPSS in responsive areas decreased ( improved ) with Tofacitinib 2, 5, and 15 mg BID vs placebo: -4.35, -4.79 and -6.32, vs -2.06, respectively ( P less than 0.0001 ).

In non-responsive areas, TPSS decreased with Tofacitinib 2, 5, and 15 mg BID versus placebo: -3.74, -4.60 and -6.15, vs -2.23, respectively ( P less than 0.01 ).

In conclusion, short-term ( 12-week ) treatment with oral Tofacitinib has produced clinical improvement across all body regions assessed in patients with moderate-to-severe plaque psoriasis, including areas typically non-responsive to treatment. ( Xagena )

Menter A et al, J Drugs Dermatol 2014;13:252-256

XagenaMedicine_2014



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