Patients with psoriatic arthritis treated with tofacitinib or adalimumab achieved quicker pain improvement compared with placebo, according to a post-hoc analysis of clinical trial data published in RMD Open.
In the study, the researchers analyzed data from two trials involving patients who were treated with tofacitinib, adalimumab, or placebo;
238 patients were prescribed 5mg of tofacitinib twice daily;
118 were given a placebo before switching to tofacitinib twice daily at month 3; and
106 were prescribed 40mg of adalimumab every two weeks.
Results from those studies were evaluated for improvement in pain (≥30%/≥50% decrease from baseline in Visual Analogue Scale pain score), as well as estimated median time to initial (first post-baseline visit)/continued (first two consecutive post-baseline visits) pain improvement.
More patients experienced pain improvements at month 3 after treatment with tofacitinib or adalimumab when compared with placebo. The median time to initial pain improvements of ≥30% and ≥50% was 55 day (95% CI, 29-57) and 85 day (95% CI, 57-92), respectively, for tofacitinib. Median time to continued pain improvement of ≥30% was 60 days (95% CI, 57-85), and continued improvement of ≥50% was 171 days (95% CI, 90-NE) for tofacitinib. Patients treated with adalimumab also had quicker pain improvements than those treated with a placebo.
Looking at the findings from the two trials, the authors noted that more patients with PsA experienced ≥30% and ≥50% improvements in pain with tofacitinib and adalimumab than with placebo in the first three months with treatment. They also said that pain improvements with treatment were “generally maintained for the duration of each trial.”
For patients treated with tofacitinib, the predicted time to pain improvement was shorter among those with higher baseline pain.
“The results of this post hoc analysis suggest that time to pain improvement with tofacitinib 5 mg twice daily in patients with PsA may be affected by their level of baseline pain severity,” the authors said. “It is possible that substantial and/or rapid reductions in pain following treatment may not be as detectable in patients with low baseline pain levels as there is less room for pain improvement in these patients.”
“This analysis provides information on when clinically meaningful improvements in pain may be expected in patients with PsA receiving tofacitinib or adalimumab, and how baseline pain severity may impact response to tofacitinib, which is of value in clinical practice,” the authors concluded.
