The Effect and Safety of Tofacitinib for Patients with Moderate to Severe Psoriasis: A Meta-Analysis of Randomized Controlled Trials / 中国药学杂志

ABSTRACT

OBJECTIVE: To review systematically the effect and safety of tofacitinib for patients with moderate to severe psoriasis. METHODS: Relevant studies were published until May 16, 2018 were identified through The Cochrane Library, PubMed, Embase, Clinical Trials.gov, CNKI, Wanfang, CBM and other web knowledge databases. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then we performed statistical analyses using the Review Manager 5.2 and Stata 12.0 software. RESULTS: Eight randomized controlled trials that compared tofacitinib vs placebo were included in the study. The final Meta-analysis included a total of 3 308 patients with psoriasis. Tofacitinib was associated with reductions in psoriasis area and severity index 75% (RR 3.27, 95%CI1.79-5.98, P=0.000 1), psoriasis area and severity index 90% (RR 12.61, 95%CI7.66-20.76, P<0.000 01), physician′s global assessment (RR 4.38, 95%CI3.51-5.47, P<0.000 01). A safety analysis showed that tofacitinib increased the risk of hypercholesterolemia (RR 2.57, 95%CI1.22-5.38, P=0.01) and tended to associate with increasing the risk of herpes zoster (RR 3.20, 95%CI0.86-11.91, P=0.08). CONCLUSION: Tofacitinib is effective and relatively safe for patients with psoriasis. Therefore, tofacitinib may be a promising treatment option for patients with moderate to severe psoriasis who had previously an inadequate response to the conventional synthetic treatment.