Patients with psoriatic arthritis-related enthesitis are more likely to persist on tofacitinib under real-life conditions.

OBJECTIVE:Information on the persistence of tofacitinib in PsA is scarce in real-life conditions. Our objective was to analyze persistence and safety of tofacitinib under these conditions. METHODS:Single-center retrospective longitudinal observational study of all PsA patients that received at least one dose of tofacitinib. Main focus was on adverse events and drug survival. Drug survival was analyzed by Kaplan-Meier curves and persistence explanatory factors by multivariate Cox regression models. The Hazard Ratio (HR) was used as a measure of the association. RESULTS:Seventy-two patients were included, 54 women and 18 men, mean age 51.9 ± 11.1 years, mean disease duration of 10.4 ± 6.99 years. Tofacitinib was ≥ 3 line of therapy in more than 70% of cases. The median survival was 13 months (IQR: 5.3-29). One-year retention rate was 52.7% (95%CI: 42.4-65.6). Tofacitinib survival was not influenced by sex, disease duration, comorbidities, or line of treatment. Younger patients (HR 0.96, p < 0.05) and those with enthesitis (HR 0.37, p < 0.05) showed lower odds of drug discontinuation. The overall adverse event (AE) rate was 52.9 (95%CI: 38.5-70.6) 100 person-year. Most AE occurred during the first 6 months of exposure. CONCLUSION:In this real-life study, tofacitinib showed a reasonably good retention rate in a PsA population mostly refractory to biologic and oral targeted-synthetic DMARDs. Patients with refractory PsA and enthesitis might be a specific target population for this drug. No new alarm signals emerged.