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Xeljanz improves nail psoriasis through 1 year

Patients with nail psoriasis who were treated with Xeljanz experienced improvement at week 16, compared with placebo, and improvements maintained through week 52, according to study results recently published in the Journal of the American Academy of Dermatology.

Joseph F. Merola, MD, MMSc, of Brigham and Women’s Hospital and Harvard Medical School, , and colleagues conducted a post-hoc analysis of pooled data from two 52-week, randomized double-blind phase 3 studies of 1,859 adults with moderate-to-severe plaque psoriasis. The patients had been treated with Xeljanz (tofacitinib, Pfizer) 5 mg, tofacitinib 10 mg or placebo twice daily. Placebo-treated patients were re-randomized to tofacitinib treatments at 16 weeks.

Joseph F. Merola

Nail Psoriasis Severity Index (NAPSI) score and proportion of patients achieving at least 50% reduction in NAPSI from baseline (NAPSI50), NAPSI75 or NAPSI100 were measured in the analysis of 1,196 patients with nail psoriasis.

A medical history of psoriatic arthritis was reported by approximately 25% of the patients with nail psoriasis.

Patients treated with tofacitinib 5 mg (n = 487), 10 mg tofacitinib (n = 476) and placebo (n = 233) twice daily had baseline mean NAPSI scores of 27, 27.3 and 26.9, respectively.

Significantly more patients receiving tofacitinib 5 mg and 10 mg twice daily achieved NAPSI50 (32.8% and 44.2%), NAPSI75 (16.9% and 28.1%) and NAPSI100 (10.3% and 18.2%) compared with placebo treatment (12.0%, 6.8% and 5.1%, respectively).

Improvements were sustained through week 52. Patients who switched from placebo to tofacitinib at week 16 achieved improvement from baseline in NAPSI score at week 52 similar to the patients who received active treatment throughout the study. Patients receiving both doses of tofacitinib experienced a decreased in the mean number of nails affected by psoriasis at week 52.

“We have demonstrated that tofacitinib 5 mg and tofacitinib 10 mg twice daily provided significant improvements in nail psoriasis vs. placebo at week 16, with improvements sustained up to 52 weeks,” the researchers concluded. – by Bruce Thiel

Disclosure: Merola reports receiving grant/research support from Biogen IDEC, being an investor for Amgen, Biogen ICEC, Pfizer and Regeneron, acting as a consultant for Biogen IDEC, participating in advisory boards for AbbVie, Amgen, Eli Lilly, Janssen, Novartis and Pfizer and being involved in the speakers’ bureau for AbbVie. Please see the full study for a list of the other researchers’ relevant financial disclosures.