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Tofacitinib is a tablet that can be taken orally unlike many of the drugs prescribed for psoriatic arthritis, which are given by injection and thus likely to cause more pain in the joint. (Photo: iStock)

Imagine being plagued by constant but unpredictable pain in your joints. You feel fine some days but experience excruciating pain and stiffness much of the time. Sometimes the pain is particularly severe in the morning but at other times it seems to never end.

Such is the case for individuals with psoriatic arthritis, a type of arthritis that often develops in individuals with a skin condition known as psoriasis. The condition occurs when the body's immune system goes rogue and begins to attack healthy tissues causing skin and joint inflammation.

Patients who have a severe form of the disease receive special drugs, known as tumor necrosis factor (TNF) inhibitors, to suppress their immune system's activity. But only half of psoriatic patients who take TNF inhibitors feel better, which is why there are ongoing efforts to develop more effective treatments for the disease.

A team led by Krembil Senior Scientist Dr. Dafna Gladman recently published a report in The New England Journal of Medicine, which examined whether a drug known as tofacitinib, which is an oral agent, is effective for those who do not respond to TNF inhibitors.

The study involved more than 350 patients, who have failed to respond to TNF inhibitors, from 14 countries who randomly received two different doses of tofacitinib or two different doses of a drug with no active ingredients (placebo).

The researchers found that tofacitinib reduced symptoms associated with psoriatic arthritis in around half of patients, and was about twice as effective as the placebo. It not only reduced joint inflammation but also improved physical function in patients and in certain cases, effectively treated the skin disease.

"We did note that a few of the patients who received tofacitinib experienced serious infections," explains Dr. Gladman. "This sometimes occurs when drugs that suppress the body's immune system are prescribed.

"These side effects will need to be considered when prescribing the medication. However, for many patients who have no other options, tofacitinib is a promising treatment for control of the arthritis."

This work was supported by Pfizer.


Dr. Dafna Gladman
The study led by Dr. Dafna Gladman found that tofacitinib reduced symptoms associated with psoriatic arthritis in around half of patients, and was about twice as effective as the placebo. (Photo: UHN)

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