Effects of the oral Janus kinase inhibitor tofacitinib on patient-reported outcomes in patients with active rheumatoid arthritis: results of two Phase 2 randomised controlled trials
Gene V Wallenstein, Keith S Kanik, Bethanie Wilkinson, Stanley Cohen, Maurizio Cutolo, Roy Fleischmann, Mark C Genovese, Juan Gomez Reino, David Gruben, Joel Kremer, Sriram Krishnaswami, Eun Bong Lee, Virginia Pascual-Ramos, Vibeke Strand, Samuel H Zwillich, Gene V Wallenstein, Keith S Kanik, Bethanie Wilkinson, Stanley Cohen, Maurizio Cutolo, Roy Fleischmann, Mark C Genovese, Juan Gomez Reino, David Gruben, Joel Kremer, Sriram Krishnaswami, Eun Bong Lee, Virginia Pascual-Ramos, Vibeke Strand, Samuel H Zwillich
Abstract
Objectives: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Here we investigated the effects of tofacitinib on patient-reported outcomes (PRO) in patients with active RA.
Methods: Two, 6-month, double-blind, placebo-controlled Phase 2b studies were performed. The combination study evaluated patients with inadequate response to methotrexate who received tofacitinib 1-15 mg twice daily (BID), 20 mg once daily or placebo, on background methotrexate. In the monotherapy study, patients with inadequate response to disease-modifying anti-rheumatic drugs received tofacitinib 1-15 mg BID, adalimumab 40 mg once every other week or placebo. PROs measured were: Patient's Assessment of Arthritis Pain (PAAP), Patient's Assessment of Disease Activity, HAQ-DI, FACIT-F and SF-36.
Results: In the combination study (n=507), significant improvements (p<0.05) versus placebo were observed at Week 12 in PAAP (visual analogue scale) and HAQ-DI for all tofacitinib groups. In the monotherapy study (n=384), significant improvements in PAAP were observed at Week 12 for tofacitinib 5, 10 and 15 mg BID, and in HAQ-DI for tofacitinib 3, 5, 10 and 15 mg BID. Significant improvements versus placebo were seen at Week 2 in PAAP (both studies) and HAQ‑DI (monotherapy study) with tofacitinib, and were maintained throughout each study. In both studies, improvements in several domains of the SF-36 in the tofacitinib groups were observed at Weeks 12 and 24.
Conclusions: In patients with active RA, tofacitinib, either in combination with methotrexate or as monotherapy, demonstrated rapid and sustained improvement in pain, physical functioning and health-related quality of life.
Trial registration: ClinicalTrials.gov NCT00413660 NCT00550446.
Source: PubMed