Psoriasis: Targets and Therapy (Aug 2019)
Tofacitinib in the management of active psoriatic arthritis: patient selection and perspectives
Abstract
Karen Ly,1 Kristen M Beck,1 Mary P Smith,1 Ana-Maria Orbai,2 Wilson Liao11Department of Dermatology, University of California San Francisco, San Francisco, CA, USA; 2Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USACorrespondence: Kristen M BeckDepartment of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USATel +1 415 476 4701Fax +1 415 502 4126Email [email protected]: Tofacitinib is an oral Janus kinase inhibitor approved for the treatment of psoriatic arthritis (PsA). It provides an alternative option for patients who have had an inadequate response and tolerance to other disease modifying antirheumatic drugs (DMARDs). It has demonstrated comparable efficacy to biologics, is effective in the management of treatment resistant disease, and is reported to improve enthesitis, dactylitis, and radiographic progression. Tofacitinib is also associated with an increased risk of serious infections, malignancy, and laboratory abnormalities. There is currently a large armamentarium of therapies for psoriatic arthritis, and choosing among treatments can be challenging. Due to this wide selection, a thorough assessment of psoriatic disease phenotype, patient preference, disease presentation, and comorbidities is critical. This review addresses key considerations in patient selection for the treatment of PsA with tofacitinib.Keywords: tofacitinib, psoriatic arthritis, janus kinase, kinase inhibitors