Open AccessEvaluating Dosage Optimality for Tofacitinib, an Oral Janus Kinase Inhibitor, in Plaque Psoriasis, and the Influence of Body Weight
Author(s) -
Hutmacher MM,
Papp K,
Krishnaswami S,
Ito K,
Tan H,
Wolk R,
Valdez H,
Mebus C,
Rottinghaus ST,
Gupta P
Publication year - 2017
Publication title -
cpt: pharmacometrics and systems pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 37
ISSN - 2163-8306
DOI - 10.1002/psp4.12182
Subject(s) - tofacitinib , janus kinase inhibitor , plaque psoriasis , medicine , psoriasis , potency , body weight , psoriasis area and severity index , population , pharmacology , body surface area , janus kinase , clinical trial , dermatology , chemistry , rheumatoid arthritis , biochemistry , environmental health , cytokine , in vitro
Tofacitinib is an oral Janus kinase inhibitor. An integrated analysis was conducted to evaluate dosage optimality for tofacitinib in patients with moderate‐to‐severe plaque psoriasis and the impact of body weight on optimality in this patient population. Data were pooled from one phase IIb trial (2, 5, and 15 mg twice daily (b.i.d.)) and four phase III trials (5 and 10 mg b.i.d.). A longitudinal exposure–response model for Psoriasis Area and Severity Index (PASI) improvement (percent change from baseline) was established. Body weight influenced potency; heavier subjects require higher doses to achieve comparable benefit to lighter subjects. Disease severity, sex, and prior biologic usage were also predictive of response. The 10 and 5 mg doses were predicted to achieve 81% and 65%, respectively, of the maximum effect based on a 75% improvement in PASI. The greater efficacy of 10 mg over 5 mg was clinically meaningful.