Mamolo C, Harness J, Tan H, Menter A
Pfizer Inc, Groton, CT, USA.
Novartis Pharma AG, Basel, Switzerland.
J Eur Acad Dermatol Venereol. 2014 Feb;28(2):192-203. doi: 10.1111/jdv.12081. Epub 2013 Jan 7.
Psoriasis is a chronic, inflammatory skin disease with a significant impact on health-related quality of life (HRQoL). Tofacitinib (CP-690,550) is a novel, oral Janus kinase inhibitor that is being investigated as a targeted immunomodulator.
This Phase 2b study assessed three tofacitinib dosage regimens vs. placebo to characterize the efficacy and safety of tofacitinib in patients with moderate-to-severe chronic plaque psoriasis. We report the patient-reported outcome (PRO) data.
A total of 197 patients were randomized to tofacitinib 2, 5, 15 mg twice daily or placebo for 12 weeks. Six PRO questionnaires were completed during the study: Dermatology Life Quality Index, Itch Severity Score (ISS), Short Form-36 questionnaire, version 2 (SF-36), Pain/Discomfort Assessment (PDA), Patient Satisfaction with Study Medication (PSSM) item and Patient Global Assessment of psoriasis.
Treatment with tofacitinib resulted in significant, dose-dependent improvements in several PROs vs. placebo from week 2 onwards. At week 12, least squares mean changes from baseline for Dermatology life quality index, ISS and SF-36 mental component scores were significantly greater for all active drug arms vs. placebo (P < 0.05), and significantly greater for tofacitinib 5 and 15 mg for SF-36 physical component scores vs. placebo (P < 0.05). At week 12, all dose groups had significantly greater numbers of patients reporting 'Clear' or 'Almost clear' on the PtGA vs. placebo.
In patients with moderate-to-severe chronic plaque psoriasis, short-term (12-week) treatment with oral twice-daily tofacitinib improves HRQoL outcomes and patient assessment of disease severity and symptoms, with an early onset noted.
银屑病是一种慢性炎症性皮肤病,对健康相关生活质量(HRQoL)有重大影响。托法替布(CP-690,550)是一种新型口服Janus激酶抑制剂,正在作为一种靶向免疫调节剂进行研究。
这项2b期研究评估了三种托法替布给药方案与安慰剂相比,在中度至重度慢性斑块状银屑病患者中托法替布的疗效和安全性。我们报告了患者报告结局(PRO)数据。
总共197例患者被随机分为每日两次服用2、5、15mg托法替布或安慰剂,疗程为12周。在研究期间完成了6份PRO问卷:皮肤病生活质量指数、瘙痒严重程度评分(ISS)、简明健康状况调查简表第2版(SF-36)、疼痛/不适评估(PDA)、患者对研究药物的满意度(PSSM)项目以及患者对银屑病的整体评估。
从第2周起,与安慰剂相比,托法替布治疗在多个PRO方面产生了显著的剂量依赖性改善。在第12周时,所有活性药物组的皮肤病生活质量指数、ISS和SF-36精神健康分量表得分相对于安慰剂从基线的最小二乘均值变化显著更大(P<0.05),对于SF-36生理健康分量表得分,托法替布5mg和15mg组相对于安慰剂显著更大(P<0.05)。在第12周时,所有剂量组中报告在患者整体评估中“清除”或“几乎清除”的患者数量相对于安慰剂显著更多。
在中度至重度慢性斑块状银屑病患者中,每日两次口服托法替布进行短期(12周)治疗可改善HRQoL结局以及患者对疾病严重程度和症状的评估,且起效较早。