Tofacitinib

A Few Good Meds #3: TOFACITINIB

It’s the NEW STEROID:
1) broadly targeting most pro-inflammatory cytokines (except TNF & IL1);
2) short-acting (fast washout in the event of side-effects);
3) fast-acting (under a week, great for therapeutic trial);
4) comes as a pill (easy storage, patient in control).
BUT without the metabolic/endocrine side-effects (almost) of steroids like weight gain, muscle weakness, bone loss, hypertension, dyslipidaemia, diabetes, insomnia, psychosis…
What’s not to like about TOFACITINIB? The PRICE $$$

Originally thought to be a specific JAK1/3 inhibitor, it’s pleiotropic targeting in clinical trials makes it a pan-JAK inhibitor.
Although Tofacitinib does not directly target TNF, IL17 & IL1 (3 pivotal cytokines in RA, SpA and JIA respectively), it can dampen inflammation in these diseases through interrupting the positive feedback loops these pro-inflammatory cytokines (eg IL2/6/12/23) participate in.

A Few Good Meds #3: TOFACITINIB in Rheumatoid Arthritis

Tofacitinib is the first in a new class of nonbiologic disease-modifying antirheumatic drugs (DMARDs), a targeted, synthetic DMARD, approved for the treatment of…
www.ncbi.nlm.nih.gov

This paper gives a good overview of the efficacy and safety of Tofacitinib in RA, as demonstrated in the ORAL trials.
It works in RA where others (csDMARDs and biologics) have failed, as Standalone, and even as First Line! Does this not take the guesswork out of RA treatment😉

A Few Good Meds #3: TOFACITINIB in Psoriasis

Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: results from two randomized, placebo-controlled, phase III trials
onlinelibrary.wiley.com

After RA, Tofacitinib is now filing for registration for Psoriasis.

A Few Good Meds #3: TOFACITINIB in other diseases

Tofacitinib is an orally active small molecule, immunosuppressant and Janus activated kinase 3 (JAK3) inhibitor that was developed by Pfizer. The design of the
adisinsight.springer.com

As further proof that Tofacitinib is the New (Designer) Steroid, it is being trialed in a whole host of diversely-mediated immune diseases. Although it has been canned in Ankylosing Spondylitis, Asthma, Crohn’s Disease, Dry eyes, Irritable Bowel Syndrome and Renal transplant rejection, it is looking good in Phase 3 for Psoriatic Arthritis, Juvenile RA and Ulcerative Colitis, and Phase 2 for Atopic Dermatitis.

A Few Good Meds #3: TOFACITINIB in Alopecia, Eczema and Vitiligo

Tofacitinib has been approved for use in rheumatoid arthritis. While attempts to prove its efficacy in psoriasis have not been successful (http://buff.ly/1R6aRF4),…
rheumnow.com

Even without FDA marketing approval or Pfizer sanctioned clinical trials, Tofacitinib is being tried off-label by all and sundry for anything vaguely autoimmune; like steroids😰. Use will spike especially for pain and aesthetic “indications” if proven efficacious; like steroids😲. Abuse is foretold when it becomes easily available; like steroids and opioids😱.