F. Satge2, 1, A. Temel1, D. Murrell1, 3
The therapeutic options to treat psoriasis are wide but, nevertheless, there are still patients not responding to one of those treatments. Xeljanz (Tofacinib) is a Janus kinase (JAK) inhibitor which inhibits one of the pathways involved in inflammation in psoriasis. Today, Tofacinib is not approved to treat psoriasis by the FDA, EMA or Therapeutic Goods Administration (TGA) due to concerns around long term safety.
Case report: A 68-year old man with a 20 years history of psoriasis was recruited into a clinical trial of Xeljanz in 2011 (“A Study To Evaluate The Effects And Safety Of Treatment, Treatment Withdrawal, Followed By Re-Treatment with CP-690,550 In Subjects With Chronic Plaque Psoriasis”) with a PASI of 12.4. He was randomised to 10mg twice daily. The trial ended in August 2012 and the patient had a PASI of 1. He started a new trial (A Phase 3, Open-Label study of the same drug) with a baseline PASI of 6.3. He completed 45 months with 10mg of Tofacinib twice daily. His PASI improved significantly down to 1.2 at the end of the trial in May 2016. Since July 2016, he is treated with Tofacinib 5mg BD thanks to compassionate supply from the manufacturer, since he did not qualify for biologics according to the Australian funding criteria. His last PASI in October 2018 was 3. During and after the trials, no significant side effects were noted in this patient. This case report shows the effectiveness and safety of Tofacitinib for individual cases of psoriasis.