Long-term safety of tofacitinib for the treatment of rheumatoid arthritis up to 8.5 years: Integrated analysis of data from the global clinical trials

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Cohen, Stanley B
Tanaka, Yoshiya
Mariette, Xavier
Curtis, Jeffrey R
Lee, Eun Bong
Nash, Peter
Winthrop, Kevin L
Charles-Schoeman, Christina
Thirunavukkarasu, Krishan
DeMasi, Ryan
Geier, Jamie
Kwok, Kenneth
Wang, Lisy
Riese, Richard
Wollenhaupt, Jürgen
Griffith University Author(s)
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2017
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Abstract

Objectives: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We report an integrated safety summary of tofacitinib from two phase I, nine phase II, six phase III and two long-term extension studies in adult patients with active RA. Methods: Data were pooled for all tofacitinib-treated patients (data cut-off: 31 March 2015). Incidence rates (IRs; patients with event/100 patient-years) and 95% CIs are reported for adverse events (AEs) of interest. Results: 6194 patients received tofacitinib for a total 19 406 patient-years' exposure; median exposure was 3.4 patient-years. IR (95% CI) for serious AEs was 9.4 (9.0 to 9.9); IR for serious infections was 2.7 (2.5 to 3.0). IR for (all) herpes zoster was 3.9 (3.6 to 4.2); IR for disseminated or multidermatomal herpes zoster was 0.3 (0.2 to 0.4). IR for opportunistic infections (excluding tuberculosis) was 0.3 (0.2 to 0.4) and was 0.2 (0.1 to 0.3) for tuberculosis. IR for malignancies (excluding non-melanoma skin cancer (NMSC)) was 0.9 (0.8 to 1.0); NMSC IR was 0.6 (0.5 to 0.7). IR for gastrointestinal perforations was 0.1 (0.1 to 0.2). Analysis of IR for serious infections, herpes zoster and malignancies by 6-month intervals did not reveal any notable increase in IR with longer-duration tofacitinib exposure. Conclusion: This analysis of tofacitinib exposure up to 8.5 years allowed estimation of safety events with improved precision versus previous tofacitinib reports. AEs were generally stable over time; no new safety signals were observed compared with previous tofacitinib reports.

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Annals of the Rheumatic Diseases

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76

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7

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© The Author(s) 2017. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Clinical sciences

Immunology

Health services and systems

Public health

Science & Technology

Life Sciences & Biomedicine

Rheumatology

ANTI-TNF THERAPY

MODIFYING ANTIRHEUMATIC DRUGS

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Cohen, SB; Tanaka, Y; Mariette, X; Curtis, JR; Lee, EB; Nash, P; Winthrop, KL; Charles-Schoeman, C; Thirunavukkarasu, K; DeMasi, R; Geier, J; Kwok, K; Wang, L; Riese, R; Wollenhaupt, J, Long-term safety of tofacitinib for the treatment of rheumatoid arthritis up to 8.5 years: Integrated analysis of data from the global clinical trials, Annals of the Rheumatic Diseases, 2017, 76 (7), pp. 1253-1262

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