Tofacitinib offers patients with rheumatic diseases ‘rapid and sustained’ pain relief
medwireNews: Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) experience significant relief from pain of varying types when treated with tofacitinib, study results suggest.
The post-hoc analysis included data on 3330 participants with RA, PsA, or AS from seven placebo-controlled, randomized trials of tofacitinib 5 or 10 mg twice a day, who were divided into five groups based on their response to prior therapies.
The 2465 RA patients and 710 PsA patients were divided according to a history of inadequate responses to conventional synthetic DMARDs or tumor necrosis factor (TNF) inhibitors, while all 155 of those with AS were intolerant or had a history of inadequate response to at least two nonsteroidal anti-inflammatory drugs (NSAIDs).
After 3 months of tofacitinib 5 mg or 10 mg, a significant proportion of RA and PsA patients reported lower levels of arthritis pain than their peers given placebo.
The percentage of patients achieving at least a 20 mm reduction in Patient’s Assessment of Arthritis Pain (PAAP), on a visual analog scale of 0–100 mm, was 53–57% among RA patients and 50–54% among PsA patients given tofacitinib, compared with a respective 28–30% and 27% among RA and PsA patients given placebo.
The researchers note that the 3-month results were similar across all four RA and PsA groups and for those taking either tofacitinib 5 or 10 mg.
“These results demonstrate that both tofacitinib doses […] are efficacious in the reduction of pain in many patients, regardless of inadequate responses to previous therapies,” say David Gruben (Pfizer Inc, Groton, Connecticut, USA) and team.
They add in RMD Open that the reduction in pain with tofacitinib at 3 months was sustained for at least 6 months, which “implies that tofacitinib efficacy in relieving pain has a rapid onset, and that efficacy may be similar between patients in more and less refractory populations.”
Gruben and colleagues highlight that the pain relief experienced by patients with RA and PsA extended beyond just arthritis pain, with significant 3-month differences versus placebo also seen for bodily pain and general pain and discomfort, measured using the Short-Form Health Survey (SF)-36v2 and the EuroQoL Five Dimensions Pain/Discomfort dimension (EQ-5D PD), respectively.
Again, this pain relief was experienced irrespective of prior inadequate responses to conventional DMARDs or TNF inhibitors.
Among the AS patients, there was no significant difference in pain levels at 3 months in terms of bodily pain or pain and discomfort between tofacitinib- and placebo-treated patients, but there was a greater reduction in the percentage of patients reporting unbearable pain or constant pain on the Ankylosing Spondylitis Quality of Life questionnaire from baseline to 12 weeks with tofacitinib than with placebo.
The researchers conclude that “tofacitinib regardless of dose, was associated with improvements across different aspects of pain across different disease types,” despite these conditions having “distinctive phenotypes and clinical pattern of presentation.”
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