Patients in the study needed to have had a PsA diagnosis of at least six months, with active plaque psoriasis at screening and inadequate response to at least one csDMARD, but with stable ongoing treatment on one csDMARD.
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A total of 422 patients were randomized to a 5 mg tofacitinib group, a 10 mg tofacitinib group, a 40 mg subcuteanous adalimumab group or a placebo group. The placebo group was switched to tofacitinib doses—half to 5 mg and half to 10 mg—at three months, after they were assessed for ACR20 criteria. At 12 months, all patients were assessed for radiographic progression.
ACR20 rates at Month 3 and rates of radiographic progression at Month 12 were superior to placebo and similar to adalimumab for the tofacitinib groups, with some patients seeing an ACR20 response as early as two weeks from the start of treatment, said Philip Mease, MD, clinical professor of rheumatology at the University of Washington.
“Tofacitinib is a potential future treatment option for psoriatic arthritis patients,” he said.
RA & Bone Loss
In a study involving data for more than 11,000 RA patients, researchers found that screening and treatment for osteoporosis can be lacking in RA. Researchers drew from the National Data Bank of Rheumatic Diseases, a prospective observational study of adult patients with RA or osteoarthritis who completed semi-annual questionnaires between January 2000 and December 2014.
Researchers found that about 50% of the RA patients were at enough risk for fracture and bone loss to warrant anti-osteoporosis treatment under the 2010 American College of Rheumatology guideline on glucocorticoid-induced osteoporosis, said Gulsen Ozen, MD, a rheumatologist and researcher with the University of Nebraska Medical Center and Marmara University in Instanbul, Turkey. But half of these patients never received any anti-osteoporosis medication.
They also found that osteoporosis or bone mineral density screening has been declining for RA patients since 2008.
Dr. Ozen said the findings show that osteoporosis care is “still suboptimal in RA and not getting better.”
“Underutilization of osteoporosis treatment and screening should be improved in RA patients, especially in male patients,” Dr. Ozen said. “Effective interventions are needed to improve this care and the burden of osteoporotic fractures.”
Thomas Collins is a freelance medical writer based in Florida.
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- Beukelman T, Xie F, Chen L, et al. Tumor necrosis factor inhibitors and the risk of malignancy in the treatment of JIA [abstract 2982]. Arthritis Rheumatol. 2016;68(suppl 10).
- Mease PJ, Hall S, FitzGerald O, et al. Efficacy and safety of tofacitinib, an oral janus kinase inhibitor, or adalimumab in patients with active psoriatic arthritis and an inadequate response to conventional synthetic DMARDs: A randomized, placebo-controlled, phase 3 trial [abstract2983]. Arthritis Rheumatol. 2016;68(suppl 10).
- Ozen G, Kamen D, Mikuls T, et al. Trends and determinants of osteoporosis preventive and management care in patients with rheumatoid arthritis compared to osteoarthritis [abstract 2986]. Arthritis Rheumatol. 2016;68(suppl 10).