Efficacy and safety of tofacitinib in older and younger patients with rheumatoid arthritis.

Academic Article

Abstract

  • OBJECTIVES: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We evaluated the efficacy and safety of tofacitinib 5 or 10 mg twice daily (BID), in patients with moderate to severe RA, aged ≥65 and <65 years. METHODS: Data were pooled from five Phase 3 trials and, separately, from two open-label long-term extension (LTE) studies (data cut-off April, 2012). Patients received tofacitinib, or placebo (Phase 3 only), with/without conventional synthetic DMARDs (mainly methotrexate). Clinical efficacy outcomes from Phase 3 studies were evaluated at Month 3. Safety evaluations using pooled Phase 3 data (Month 12) and pooled LTE data (Month 24) compared exposure-adjusted incidence rates (IRs; with 95% confidence intervals [CIs]), in older versus younger patients. RESULTS: In Phase 3 and LTE studies, 15.3% (475/3111) and 16.1% (661/4102) of patients, respectively, were aged ≥65 years. Consequently, exposure to tofacitinib was lower in older versus younger patients in Phase 3 (259.2 vs. 1554.9 patient years [pt-yrs]) and LTE (962.1 vs. 5071.7 pt-yrs) studies. Probability ratios for ACR responses and HAQ-DI improvement from baseline ≥0.22 (Month 3) favoured tofacitinib and were similar in older and younger patients, with overlapping CIs. IRs for SAEs and discontinuations due to AEs were generally numerically higher in older versus younger patients, irrespective of treatment. CONCLUSIONS: Older patients receiving tofacitinib 5 or 10 mg BID had a similar probability of ACR20 or ACR50 response and, due to comorbidities, a numerically higher risk of SAEs and discontinuations due to AEs compared with younger patients.
  • Keywords

  • Administration, Oral, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Antirheumatic Agents, Arthritis, Rheumatoid, Clinical Trials, Phase III as Topic, Comorbidity, Drug Administration Schedule, Female, Humans, Janus Kinases, Male, Middle Aged, Patient Safety, Piperidines, Protein Kinase Inhibitors, Pyrimidines, Pyrroles, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Young Adult
  • Author List

  • Curtis JR; Schulze-Koops H; Takiya L; Mebus CA; Terry KK; Biswas P; Jones TV
  • Start Page

  • 390
  • End Page

  • 400
  • Volume

  • 35
  • Issue

  • 3