Rheumatology Department, Hospital Universitari Parc Taulí Sabadell, Medicine Department UAB, Barcelona, Spain.
CEIMI, Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Adv Ther. 2021 Feb;38(2):868-884. doi: 10.1007/s12325-020-01585-7. Epub 2020 Dec 17.
Therapeutic approaches for psoriatic arthritis (PsA) include non-pharmacologic therapies, symptomatic treatments, tumor necrosis factor inhibitors, interleukin inhibitors, cytotoxic T lymphocyte antigen 4 immunoglobulin, and Janus kinase inhibitors. This systematic review aimed to provide complete and up-to-date information on efficacy of tofacitinib in the treatment of PsA, giving special attention to non-skin manifestations (peripheral arthritis, axial disease, enthesitis, and dactylitis).
A search of studies published between January 2016 and June 2020 was carried out on PubMed and Google Scholar.
The number of studies with tofacitinib in PsA is limited and most of them are post hoc analyses from OPAL Broaden and OPAL Beyond. Tofacitinib has been demonstrated to be efficacious for the treatment of all disease manifestations in PsA. Superior effectivity to placebo is achieved at the earliest time point evaluated, and maintained over time. Patients who switch from placebo to tofacitinib show the same improvements; however, the time to initial response is faster in patients who firstly receive tofacitinib, compared with those switching subsequently. Additional data suggest that tofacitinib may be also effective for the treatment of the axial domain.
Tofacitinib has been demonstrated to be efficacious for the treatment of peripheral and axial involvement, enthesitis, and dactylitis manifestation in PsA. Further prospective and long-term studies are required to corroborate and complete the present results. Similarly, real-world evidence is also necessary to complement the information obtained in clinical trials, and thereby to have a better overview of real efficacy and safety of the drug.
治疗银屑病关节炎（PsA）的方法包括非药物治疗、对症治疗、肿瘤坏死因子抑制剂、白介素抑制剂、细胞毒性 T 淋巴细胞抗原 4 免疫球蛋白和 Janus 激酶抑制剂。本系统评价旨在提供托法替尼治疗 PsA 疗效的完整和最新信息，特别关注非皮肤表现（外周关节炎、轴性疾病、附着点炎和指炎）。
在 PubMed 和 Google Scholar 上检索了 2016 年 1 月至 2020 年 6 月期间发表的研究。
托法替尼治疗 PsA 的研究数量有限，且大多数为 OPAL Broaden 和 OPAL Beyond 的事后分析。托法替尼已被证明对治疗 PsA 的所有疾病表现均有效。在最早评估的时间点就达到了优于安慰剂的效果，并随着时间的推移得以维持。从安慰剂转换为托法替尼的患者也表现出同样的改善；然而，与随后转换的患者相比，首次接受托法替尼的患者初始反应更快。额外的数据表明，托法替尼可能对治疗轴性疾病也有效。
托法替尼已被证明对治疗 PsA 的外周和轴性受累、附着点炎和指炎表现有效。需要进一步的前瞻性和长期研究来证实和完善目前的结果。同样，真实世界的证据也有必要补充临床试验中获得的信息，从而更好地了解药物的实际疗效和安全性。
