The effect of tofacitinib on residual pain in patients with rheumatoid arthritis and psoriatic arthritis

Maxime Dougados; Peter C Taylor; Clifton O Bingham 3rd; Lara Fallon; Yves Brault; Satrajit Roychoudhury; Lisy Wang; Meriem Kessouri

doi:10.1136/rmdopen-2022-002478

The effect of tofacitinib on residual pain in patients with rheumatoid arthritis and psoriatic arthritis

RMD Open. 2022 Sep;8(2):e002478. doi: 10.1136/rmdopen-2022-002478.

Authors

Maxime Dougados¹, Peter C Taylor², Clifton O Bingham 3rd³, Lara Fallon⁴, Yves Brault⁵, Satrajit Roychoudhury⁶, Lisy Wang⁷, Meriem Kessouri⁵

Affiliations

¹ Department of Rheumatology, Hôpital Cochin, Université de Paris, Paris, France maxime.dougados@aphp.fr.
² Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
³ Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA.
⁴ Global Medical Affairs, Rheumatology, Pfizer Inc, Montreal, Quebec, Canada.
⁵ Pfizer Inc, Paris, France.
⁶ Pfizer Inc, New York, New York, USA.
⁷ Global Product Development, Pfizer Inc, Groton, Connecticut, USA.

Abstract

Objective: Post hoc analysis of pooled data from nine randomised controlled trials to assess the effect of tofacitinib (oral Janus kinase inhibitor for treatment of rheumatoid arthritis (RA) and psoriatic arthritis (PsA)) on residual pain in patients with RA or PsA with abrogated inflammation.

Methods: Patients who received ≥1 dose of tofacitinib 5 mg twice daily, adalimumab or placebo with/without background conventional synthetic disease-modifying antirheumatic drugs and had abrogated inflammation (swollen joint count (SJC)=0 and C reactive protein (CRP)<6 mg/L) after 3 months' therapy were included. Assessments included Patient's Assessment of Arthritis Pain at month 3 (Visual Analogue Scale [VAS] 0-100 mm). Scores were summarised descriptively; treatment comparisons assessed by Bayesian network meta-analyses (BNMA).

Results: From the total population with RA/PsA, 14.9% (382 of 2568), 17.1% (118 of 691) and 5.5% (50 of 909) of patients receiving tofacitinib, adalimumab and placebo, respectively, had abrogated inflammation after 3 months' therapy. Patients with RA/PsA with abrogated inflammation receiving tofacitinib/adalimumab had higher baseline CRP versus placebo; patients with RA receiving tofacitinib/adalimumab had lower SJC and longer disease duration versus placebo. Median residual pain (VAS) at month 3 was 17.0, 19.0 and 33.5 in patients with RA treated with tofacitinib, adalimumab or placebo, and 24.0, 21.0 and 27.0 in patients with PsA, respectively. Residual pain reductions with tofacitinib/adalimumab versus placebo were less prominent in patients with PsA versus patients with RA, with no significant differences between tofacitinib/adalimumab, per BNMA.

Conclusion: Patients with RA/PsA with abrogated inflammation receiving tofacitinib/adalimumab had greater residual pain reduction versus placebo at month 3. Results were similar between tofacitinib and adalimumab.

Trial registration number: ClinicalTrials.gov registry (NCT00960440; NCT00847613; NCT00814307; NCT00856544; NCT00853385; NCT01039688; NCT02187055; NCT01877668; NCT01882439).

Keywords: Arthritis, Psoriatic; Arthritis, Rheumatoid; Inflammation.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adalimumab / therapeutic use
Arthritis, Psoriatic* / drug therapy
Arthritis, Rheumatoid* / drug therapy
Bayes Theorem
C-Reactive Protein
Humans
Inflammation / drug therapy
Pyrroles / therapeutic use
Treatment Outcome

Substances

Adalimumab
C-Reactive Protein
Pyrroles
tofacitinib

Associated data

ClinicalTrials.gov/NCT02187055
ClinicalTrials.gov/NCT00960440
ClinicalTrials.gov/NCT00814307
ClinicalTrials.gov/NCT00847613
ClinicalTrials.gov/NCT01877668
ClinicalTrials.gov/NCT00856544
ClinicalTrials.gov/NCT01039688
ClinicalTrials.gov/NCT00853385
ClinicalTrials.gov/NCT01882439