AB0845 TOFACITINIB IMPROVES DISEASE ACTIVITY AND PATIENT-REPORTED OUTCOMES (PROs) IN PATIENTS (pts) WITH ACTIVE PSORIATIC ARTHRITIS (PsA) IN REAL CLINICAL PRACTICE.
Authors: T. Korotaeva, L. Vorobyova, E. Loginova, E. Gubar, Y. Korsakova, S. Glukhova, P. Karpova
Journal: Annals of the Rheumatic Diseases (2020)

Background: PsA is a disease with multiple manifestations; it has significant impact on physical and emotional aspects of pts’ life. PROs as well as disease activity are an important instrument for assessing treatment response. Tofacitinib (TF) is an oral Janus kinase inhibitor; in RCT TF demonstrated efficacy in active PsA pts concerning PROs [1] but there is currently no evidence from real clinical practice. Objectives: to study the influence of TF on disease activity and PROs in 3/6 months (mo) of therapy in pts with active PsA in clinical practice. Methods: 41(M/F=24(58.5%)/17(41.5%) PsA pts fulfilling the CASPAR criteria were included. Mean age 42.4±10.3 years (yrs), median (Me) PsA duration 72 [35;120] mo, pts had inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs, mostly Methotrexate)/biological (b) DMARDs (29% of pts). Pts were treated with TF 5 mg twice daily after signing consent participation forms. At baseline (BL) and in 3/6 mo of therapy PsA activity was evaluated by Tender Joint Count (TJC68), Swollen Joint Count (SJC66); PGA, physician global assessment by Visual Analog Scale (VAS), DAPSA. PROs were measured by PtGA VAS, PtPain VAS, BASDAI, HAQ, DLQI, RAPID, FACIT, PsAID12, P atient- A cceptable S ymptom S tate (PASS) of PsAID12≤4. PsAID12 was analyzed as a change above the minimal clinical important difference (MCID) -1.25 points [2]. Higher PsAID12 scores are considered to be worse and correspond to poorer PsA-specific health-related quality of life. M±SD, Me [Q25; Q75], %, t-test, Pierson-χ 2 , Manna-Whitney tests were performed. All p&lt;0.05 were considered to indicate statistical significance. Results: At BL 87.8% of pts had high PsA activity by DAPSA. By 3/6 mo of therapy significant improvement in all PsA activity indexes and PROs were observed (table 1) (for all p&lt;0.0001). By 6 mo of therapy DAPSA remission was seen in 11 out of 41 pts (26.8%). After 3/6 mo of therapy all PsAID12 domains demonstrated significant improvement (p&lt;0.0001) (Figure 1). The PsAID12 improvement above MCID in -1.25 points reached 90.2% of pts by 6 mo. In 3/6 mo of therapy PsAID12 PASS was achieved in 66.7%/71.8% pts accordingly. Table 1. Change in all evaluated parameters from BL to 3/6 mo. Parameters, M±SD BL 3 mo 6 mo TJC68 18.1 ±9.8 6.3±6.9* 4.9±5.0** SJC66 12.8±7.7 3.7±4.3* 2.5±4.0** BASDAI 6.0±1.7 2.2±1.63* 1.77±1.42** DAPSA 44.2±17.1 15.2±12.4* 11.8±9.4** CRP (mg/l) 27.4±29.3 5.1±7.8* 6.2±11.6** PtPain, VAS, mm 65 [50; 75] 20 [10;30]* 18 [5;30]* PtGA, VAS, mm 70 [50; 80] 23 [14; 35]* 20 [10; 30]** ESR (mm/h) 32±25.5 14.8±16,3* 13.6±16.3** Total PsAID12 score (over past week, 0-10) 5.18±2.14 2.07±1.65* 1.68±1.48** PsAID12 PASS, % 25.6 66.7 71.8 HAQ 1 [0.625; 1.5] 0.5 [0.125; 0.875]* 0.5 [0; 0.875]** DLQI 5 [2; 12] 2 [0; 6]* 2 [0; 4]** FACIT 29 [23;38] 39.5 [31.5; 48]* 38 [32;45]** RAPID 16 [13.3; 18.6] 6.5 [3.7; 9.1]* 5 [2.3; 8.3]** *p&lt;0.0001 – differences from BL to 3 mo; ** p&lt;0.0001 – differences from BL/6 mo; Figure 1. PsAID12 domains at BL and at 3/6 mo of TF treatment. Conclusion: In real clinical practice TF provides significant and clinically considerable improvement of PsA activity and PROs, including pain, psychological and emotional status. References: [1]Strand V, et al. RMD Open 2019;5:e000806. doi:10.1136/rmdopen-2018-000806. [2]Holland R, et al. Ann Rheum Dis. 2018;77:343-47. Disclosure of Interests: Tatiana Korotaeva Consultant of: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Speakers bureau: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Lyubov Vorobyova: None declared, Elena Loginova Speakers bureau: Janssen, ELENA GUBAR: None declared, Yulia Korsakova: None declared, Svetlana Glukhova: None declared, Polina Karpova: None declared