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• W2894900585 abstract "Background Tofacitinib is an oral JAK inhibitor for the treatment of psoriatic arthritis (PsA). Objectives To perform a systematic literature review (SLR) and network meta-analysis (NMA) to evaluate the efficacy of tofacitinib 5 and 10 mg BID relative to biologic disease-modifying antirheumatic drugs (bDMARDs) or a targeted synthetic DMARD (apremilast [APR]) in tumour necrosis factor inhibitor-naive (TNFi-N) patients with active PsA. Methods The SLR identified randomised controlled clinical trials (RCTs) evaluating tofacitinib, bDMARDs or APR to treat patients with active PsA who were TNFi-N. Outcomes included American College of Rheumatology (ACR)20 response and change from baseline in Health Assessment Questionnaire-Disability Index (ΔHAQ-DI), Dactylitis Severity Score (ΔDSS) and Leeds Enthesitis Index (ΔLEI). Treatment effects were only evaluated during placebo (PBO)-controlled trial phases. The Bayesian NMA (with non-informative priors) was conducted using WinBUGs. The binomial logit model was used for ACR20. ΔHAQ-DI, ΔDSS and ΔLEI were analysed using the normal identify link model. A fixed-effect model was fitted to the data. Median treatment rankings represent data from each iteration of the model from which inferences are based, following model convergence. Results The SLR identified 25 RCTs and 21 were included in the NMA (see treatments in table 1). All trials allowed methotrexate use. PBO-controlled treatment durations ranged from 12–24 weeks. In general, patient characteristics were similar across trials. All treatments were associated with improvements in ACR20 and ΔHAQ-DI vs PBO. Tofacitinib 5 mg BID was associated with substantially decreased odds ratios (ORs) for ACR20 vs golimumab 50 and 100 mg Q4W, etanercept 25 mg BW, infliximab 5 mg/kg and secukinumab 150 mg QW-Q4W (table 1); ORs for all remaining comparators were not substantially different. Tofacitinib 10 mg BID was associated with a substantially increased OR for ACR20 vs APR 20 mg BID. Etanercept was associated with an improvement in ΔHAQ-DI vs tofacitinib 5 and 10 mg BID. There was no difference in ΔHAQ-DI for tofacitinib vs other bDMARDs. For ACR20, tofacitinib 5 and 10 mg BID were median ranked 14 (95% credible interval: 8, 17) and 9,5, 14 respectively, among 18 comparators. For ΔHAQ-DI, tofacitinib 5 and 10 mg BID were median ranked 114, 13 and 8,2, 13 respectively, among 14 comparators. Two studies evaluated ΔDSS and ΔLEI; there were no substantial differences in ΔDSS and ΔLEI for tofacitinib 5 and 10 mg BID vs adalimumab 40 mg Q2W and ixekizumab 80 mg Q2W and Q4W. Conclusions Based on the NMA of published RCTs in TNFi-N patients with PsA, tofacitinib 5 and 10 mg BID had similar efficacy vs many, but not all, bDMARDs and APR in improving ACR20 and ΔHAQ-DI. Acknowledgements Study sponsored by Pfizer Inc. Medical writing support was provided by P Scutt of CMC and funded by Pfizer Inc. Disclosure of Interest D. Gladman Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, Consultant for: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, A.-M. Orbai Grant/research support from: Celgene, Eli Lilly, Horizon, Janssen, Novartis, Pfizer Inc, UCB, Consultant for: Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, J. Gomez-Reino Grant/research support from: AbbVie, MSD, Pfizer Inc, Roche, Consultant for: Pfizer Inc, Speakers bureau: AbbVie, Biogen, Bristol-Myers Squibb, Janssen, MSD, Pfizer Inc and Roche, S. Chang-Douglass Employee of: Decision Resources Group, E. Leoncini Employee of: Decision Resources Group, H. Burton Employee of: Decision Resources Group, K. Kanik Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, T. Hendrikx Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, J. Cappelleri Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, M.-A. Hsu Shareholder of: Pfizer Inc, Employee of: Pfizer Inc" @default.
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• W2894900585 date "2018-06-01" @default.
• W2894900585 modified "2023-10-18" @default.
• W2894900585 title "THU0300 Network meta-analysis of tofacitinib vs bdmards or apremilast for the treatment of tnf inhibitor-naÏve patients with psoriatic arthritis" @default.
• W2894900585 doi "https://doi.org/10.1136/annrheumdis-2018-eular.4823" @default.
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