Jashin J Wu1, Bruce E Strober2, Peter R Hansen3, Ole Ahlehoff4, Alexander Egeberg5, Abrar A Qureshi6, Debbie Robertson7, Hernan Valdez8, Huaming Tan9, Robert Wolk9. 1. Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. Electronic address: jashinwu@gmail.com. 2. University of Connecticut Health Center, Farmington, Connecticut; Probity Medical Research, Waterloo, Ontario, Canada. 3. Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark. 4. Department of Cardiology, Copenhagen University Hospital Rigshospitalet, The Heart Centre, Copenhagen, Denmark. 5. Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark; Department of Dermato-Allergology, Herlev and Gentofte Hospital, Hellerup, Denmark. 6. Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island. 7. Pfizer location in Collegeville, Collegeville, Pennsylvania. 8. Pfizer location in New York, New York, New York. 9. Pfizer location in Groton, Groton, Connecticut.
Abstract
BACKGROUND: Psoriasis is a systemic inflammatory condition that is associated with a higher risk of cardiovascular (CV) disease. Tofacitinib is being investigated as a treatment for psoriasis. OBJECTIVE: We sought to evaluate the effects of tofacitinib on CV risk factors and major adverse CV events (MACEs) in patients with plaque psoriasis. METHODS: Changes in select CV risk factors and the incidence rate (IR) of MACEs were evaluated in patients who were treated with tofacitinib. RESULTS: Tofacitinib treatment was associated with small, dose-dependent increases in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, while the total/HDL cholesterol ratio was unchanged. There were no changes in blood pressure and glycated hemoglobin levels; C-reactive protein levels decreased. The IRs of a MACE were low and similar for both tofacitinib doses. Among 3623 subjects treated with tofacitinib, the total patient-years of exposure was 5204, with a median follow-up of 527 days, and the IR of MACEs was 0.37 (95% confidence interval, 0.22-0.57) patients with events per 100 patient-years. LIMITATIONS: There was relatively short follow-up time for patients who had MACEs. CONCLUSIONS: While treatment with tofacitinib is associated with a small increase in cholesterol levels, the total/HDL cholesterol ratio does not change, there are no unfavorable changes in several CV risk factors, and the incidence of MACEs is low.
BACKGROUND:Psoriasis is a systemic inflammatory condition that is associated with a higher risk of cardiovascular (CV) disease. Tofacitinib is being investigated as a treatment for psoriasis. OBJECTIVE: We sought to evaluate the effects of tofacitinib on CV risk factors and major adverse CV events (MACEs) in patients with plaque psoriasis. METHODS: Changes in select CV risk factors and the incidence rate (IR) of MACEs were evaluated in patients who were treated with tofacitinib. RESULTS:Tofacitinib treatment was associated with small, dose-dependent increases in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, while the total/HDL cholesterol ratio was unchanged. There were no changes in blood pressure and glycated hemoglobin levels; C-reactive protein levels decreased. The IRs of a MACE were low and similar for both tofacitinib doses. Among 3623 subjects treated with tofacitinib, the total patient-years of exposure was 5204, with a median follow-up of 527 days, and the IR of MACEs was 0.37 (95% confidence interval, 0.22-0.57) patients with events per 100 patient-years. LIMITATIONS: There was relatively short follow-up time for patients who had MACEs. CONCLUSIONS: While treatment with tofacitinib is associated with a small increase in cholesterol levels, the total/HDL cholesterol ratio does not change, there are no unfavorable changes in several CV risk factors, and the incidence of MACEs is low.
Authors: Dafna D Gladman; Christina Charles-Schoeman; Iain B McInnes; Douglas J Veale; Bruce Thiers; Mike Nurmohamed; Dani Graham; Cunshan Wang; Thomas Jones; Robert Wolk; Ryan DeMasi Journal: Arthritis Care Res (Hoboken) Date: 2019-10 Impact factor: 4.794
Authors: Bruce E Sands; Jean-Frédéric Colombel; Christina Ha; Michel Farnier; Alessandro Armuzzi; Daniel Quirk; Gary S Friedman; Kenneth Kwok; Leonardo Salese; Chinyu Su; Pam R Taub Journal: Inflamm Bowel Dis Date: 2021-05-17 Impact factor: 5.325