PMID- 38517652
OWN - NLM
STAT- MEDLINE
DCOM- 20240416
LR  - 20240416
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 43
IP  - 5
DP  - 2024 May
TI  - Efficacy and safety of tofacitinib for chronic plaque psoriasis and psoriatic 
      arthritis: a systematic review and meta-analysis of randomized controlled trials.
PG  - 1605-1613
LID - 10.1007/s10067-024-06940-5 [doi]
AB  - OBJECTIVES: To summarize and analyze the results of published randomized 
      controlled trials of tofacitinib for the treatment of chronic plaque psoriasis 
      and psoriatic arthritis(PsA) and discuss its efficacy and safety. PATIENTS AND 
      METHODS: An exhaustive systematic search encompassing PubMed, Cochrane, Embase, 
      and Web of Science databases was conducted up to July 2023. Studies eligible for 
      inclusion were analyzed, organized using Review Manager version 5.4.1 (Cochrane 
      Collaboration, Oxford, UK) and STATA 15.0 version (Stata Corp, College Station, 
      TX, USA) software. RESULTS: A total of six articles, covering 1393 patients (844 
      treated with tofacitinib and 549 with placebo), were included. The foundational 
      characteristics of tofacitinib and placebo group showed similarity, except for 
      age and Dermatology Life Quality Index (DLQI) score, especially in the context of 
      chronic plaque psoriasis. It is noteworthy that we discovered tofacitinib 
      exhibited a significant impact on Psoriasis Area and Severity Index 75 (PASI75) 
      response, Physician's Global Assessment (PGA) response, and adverse events (AEs) 
      in cases of chronic plaque psoriasis. Similarly, tofacitinib demonstrated 
      substantial influence on American College of Rheumatology 20/50 (ACR20/50) 
      response, PASI75 response, as well as alterations in Functional Assessment of 
      Chronic Illness Therapy-Fatigue (FACIT-F) Score, Health Assessment 
      Questionnaire-Disability Index (HAQ-DI) Score, Dactylitis Severity Score (DSS), 
      and Leeds Enthesitis Index (LEI) Score in the context of psoriatic arthritis 
      (PsA). Nevertheless, there was no statistically significant impact of tofacitinib 
      on serious adverse events (SAEs) in chronic plaque psoriasis, as well as on both 
      adverse events (AEs) and SAEs in psoriatic arthritis (PsA). CONCLUSIONS: A 
      comprehensive analysis revealed that tofacitinib has a positive effect on 
      addressing skin and joint symptoms, as well as improving the quality of life for 
      patients with chronic plaque psoriasis and psoriatic arthritis (PsA). However, 
      the safety of the drug's long-term usage even requires further validation. Key 
      Points * In 6 analyses involving a total of 1393 patients, tofacitinib exhibits 
      positive effect on the treatment of both chronic plaque psoriasis and psoriatic 
      arthritis (PsA). * Although dose-based subgroup analyses have demonstrated 
      effectiveness. Some studies indicate that the 5-mg dose (twice daily) may not 
      show an effect due to the failure of non-inferiority trials comparing tofacitinib 
      with placebo. Therefore, caution is required when interpreting its effectiveness. 
      On the other hand, the 10-mg dose (BID) has been associated with an increase in 
      adverse events and serious adverse events, and is recommended to be used with 
      caution in patients with cardiovascular or uveitis risk factors. * Tofacitinib 
      has efficacy in comorbid psychiatric disorders (depression, anxiety, or 
      Alzheimer's disease) and inflammatory bowel disease (ulcerative colitis), but 
      patients with comorbid renal insufficiency, hepatic dysfunction, osteoporosis, 
      cardiovascular disease, or uveitis may need to be moderated or avoided with 
      tofacitinib.
CI  - (c) 2024. The Author(s), under exclusive licence to International League of 
      Associations for Rheumatology (ILAR).
FAU - Dai, Qianqian
AU  - Dai Q
AD  - Tianjin University of Traditional Chinese Medicine, Tianjin, China.
AD  - Department of Dermatology, Shushan TCM Clinic, Anhui Xin'an TCM Medical Service 
      Co., LTD, Hefei, China.
FAU - Zhang, Yanfeng
AU  - Zhang Y
AD  - Tianjin University of Traditional Chinese Medicine, Tianjin, China.
AD  - Department of Dermatology, Tangshan Fengnan Hospital of Traditional Chinese 
      Medicine, Tangshan, China.
FAU - Liu, Qian
AU  - Liu Q
AD  - Department of Dermatology, Shushan TCM Clinic, Anhui Xin'an TCM Medical Service 
      Co., LTD, Hefei, China.
AD  - Anhui University of Traditional Chinese Medicine, Hefei, China.
FAU - Zhang, Chijin
AU  - Zhang C
AUID- ORCID: 0009-0007-6839-9539
AD  - Department of Dermatology, First Teaching Hospital of Tianjin University of 
      Traditional Chinese Medicine, Tianjin, China. 377153321@qq.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20240322
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 87LA6FU830 (tofacitinib)
RN  - 0 (Piperidines)
RN  - 0 (Pyrimidines)
SB  - IM
MH  - Humans
MH  - *Arthritis, Psoriatic/drug therapy
MH  - Quality of Life
MH  - Treatment Outcome
MH  - Randomized Controlled Trials as Topic
MH  - *Psoriasis/drug therapy
MH  - *Uveitis
MH  - *Piperidines
MH  - *Pyrimidines
OTO - NOTNLM
OT  - Chronic plaque psoriasis
OT  - Psoriatic arthritis
OT  - Tofacitinib
EDAT- 2024/03/22 18:44
MHDA- 2024/04/16 12:43
CRDT- 2024/03/22 12:24
PHST- 2023/12/03 00:00 [received]
PHST- 2024/03/13 00:00 [accepted]
PHST- 2024/03/02 00:00 [revised]
PHST- 2024/04/16 12:43 [medline]
PHST- 2024/03/22 18:44 [pubmed]
PHST- 2024/03/22 12:24 [entrez]
AID - 10.1007/s10067-024-06940-5 [pii]
AID - 10.1007/s10067-024-06940-5 [doi]
PST - ppublish
SO  - Clin Rheumatol. 2024 May;43(5):1605-1613. doi: 10.1007/s10067-024-06940-5. Epub 
      2024 Mar 22.