TY - JOUR T1 - Treatment With Tofacitinib in Refractory Psoriatic Arthritis: A National Multicenter Study of the First 87 Patients in Clinical Practice JF - The Journal of Rheumatology JO - J Rheumatol SP - 1552 LP - 1558 DO - 10.3899/jrheum.201204 VL - 48 IS - 10 AU - Eva Galíndez-Agirregoikoa AU - Diana Prieto-Peña AU - José Luis Martín-Varillas AU - Beatriz Joven AU - Olga Rusinovich AU - Rafael B. Melero-González AU - Francisco Ortiz-Sanjuan AU - Raquel Almodóvar AU - Juan José Alegre-Sancho AU - Ángels Martínez AU - Agustí Sellas-Fernández AU - Lara Méndez AU - Rosario García-Vicuña AU - Belén Atienza-Mateo AU - Iñigo Gorostiza AU - Miguel Ángel González-Gay AU - Ricardo Blanco Y1 - 2021/10/01 UR - http://www.jrheum.org/content/48/10/1552.abstract N2 - Objective. Tofacitinib (TOF) is the first Janus kinase (JAK) inhibitor approved for psoriatic arthritis (PsA). It has shown efficacy in patients refractory to anti–tumor necrosis factor-α in randomized controlled trials (RCTs). Our aim was to assess efficacy and safety of TOF in clinical practice.Methods. This was an observational, open-label multicenter study of PsA patients treated with TOF due to inefficacy or adverse events of previous therapies. Outcome variables were efficacy, corticosteroid dose-sparing effect, retention rate, and safety. A comparative study of clinical features between our cohort of patients and those from the OPAL Beyond trial was performed.Results. There were 87 patients (28 women/59 men), with a mean age of 52.8 ± 11.4 years. All patients were refractory to biologic disease-modifying antirheumatic drugs (DMARDs) and/or to conventional synthetic DMARDs plus apremilast. TOF was started at 5 mg twice daily after a mean follow-up of 12.3 ± 9.3 years from PsA diagnosis. At first month, Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) decreased from median 4.8 (IQR 4.1–5.4) to 3.7 (IQR 2.8–4.7, P < 0.01), Disease Activity Index for Psoriatic Arthritis from median 28 (IQR 18.4–34.1) to 15.5 (IQR 10.1–25.7, P < 0.01), and C-reactive protein from median 1.9 (IQR 0.3–5.0) to 0.5 (IQR 0.1–2.2) mg/dL (P < 0.01). Also, TOF led to a significant reduction in prednisone dose. Mild adverse effects were reported in 21 patients (24.13%), mainly gastrointestinal symptoms. TOF retention rate at Month 6 was 77% (95% CI 65.2–86.3). Patients in clinical practice were older with longer disease duration and received biologic agents more commonly than those in the OPAL Beyond trial.Conclusion. Data from clinical practice confirm that TOF seems to be effective, rapid, and relatively safe in refractory PsA despite clinical differences with patients in RCTs. ER -