Abstract

Background:Tofacitinib is an oral JAK inhibitor for the treatment of psoriatic arthritis (PsA). The efficacy and safety of tofacitinib for PsA have been demonstrated in Phase 3 trials of up to 12 months’ (mos) duration.1,2Objectives:To describe demographic, treatment and disease characteristics of a sample of patients (pts) at initiation of tofacitinib for PsA in the United States (US), France, Germany, Italy, Spain and the United Kingdom (European Union Five; EU5).Methods:An online, retrospective medical chart review of de-identified pts treated with tofacitinib for PsA from the US and the EU5 was conducted by Ipsos Rheumatology Monitor between Sept and Dec 2019, after product approval for PsA (US, 5 mg twice daily [BID] and 11 mg once daily [QD]: Dec 2017; EU, 5 mg BID: June 2018). Rheumatology healthcare professionals (HCPs), recruited from a large panel, selected a sample of charts of pts ≥18 years of age who had a HCP-reported diagnosis of PsA and were prescribed tofacitinib. Extracted data included pt demographics, treatment characteristics (including treatments prior to tofacitinib) and disease characteristics at tofacitinib initiation (including HCP-reported disease severity).Results:Of 1564 pts (US n=436; EU5 n=1128, respectively) sampled by 391 HCPs, the majority were White (75%; 91%), female (both 52%) and 45–64 years of age (53%; 57%). At time of chart review, US pts had received tofacitinib for median (interquartile range [IQR]) 9 (7–11) mos, and EU5 pts for 7 (6–9) mos; 52% of US pts received 11 mg QD, and 84% of EU5 pts received 5 mg BID. Median (IQR) time from PsA diagnosis to tofacitinib initiation was 34 (12–68) mos for all pts with data available (n=1237), and was shorter for US (11 [3–33] mos) vs EU5 (40 [19–79] mos) pts. Most pts had received ≥1 prior targeted therapy (59%; biologic or targeted synthetic disease-modifying antirheumatic drugs) for median (IQR) 12 (7–22) mos. The most common HCP-reported reason for switching from prior targeted therapy was efficacy failure (US and EU5 both 59%); either initial failure (US 28%; EU5 13%) or long-term failure (US 34%; EU5 48%) (Figure 1A). Mechanism of action and mode of administration were the most common HCP-reported reasons for switching to tofacitinib in both the US and EU5 (Figure 1B). HCP-reported disease severity at tofacitinib initiation was higher in the EU5 than US (Figure 2).Conclusion:Characteristics of pts treated with tofacitinib for PsA were generally similar in the US and EU5. However, time from PsA diagnosis to tofacitinib initiation was shorter in the US vs EU5. It was of clinical interest to note that switching to tofacitinib appeared to be more commonly influenced by mechanism of action and mode of administration vs pt preference and access, as reported by HCPs. A key limitation of this study was the retrospective chart review design, which may introduce recall bias.

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