title: Effects of tofacitinib on cardiovascular risk factors and cardiovascular outcomes based on phase III and long-term extension data in patients with plaque psoriasis.
abstract: BACKGROUND
  Psoriasis is a systemic inflammatory condition that is associated with a higher risk of cardiovascular (CV) disease. Tofacitinib is being investigated as a treatment for psoriasis.
  
  
  OBJECTIVE
  We sought to evaluate the effects of tofacitinib on CV risk factors and major adverse CV events (MACEs) in patients with plaque psoriasis.
  
  
  METHODS
  Changes in select CV risk factors and the incidence rate (IR) of MACEs were evaluated in patients who were treated with tofacitinib.
  
  
  RESULTS
  Tofacitinib treatment was associated with small, dose-dependent increases in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, while the total/HDL cholesterol ratio was unchanged. There were no changes in blood pressure and glycated hemoglobin levels; C-reactive protein levels decreased. The IRs of a MACE were low and similar for both tofacitinib doses. Among 3623 subjects treated with tofacitinib, the total patient-years of exposure was 5204, with a median follow-up of 527 days, and the IR of MACEs was 0.37 (95% confidence interval, 0.22-0.57) patients with events per 100 patient-years.
  
  
  CONCLUSIONS
  There was relatively short follow-up time for patients who had MACEs.
  
  
  CONCLUSIONS
  While treatment with tofacitinib is associated with a small increase in cholesterol levels, the total/HDL cholesterol ratio does not change, there are no unfavorable changes in several CV risk factors, and the incidence of MACEs is low.
authors: Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. Electronic address: jashinwu@gmail.com.
authors: Jashin J
authors: JJ
authors: Wu
authors: University of Connecticut Health Center, Farmington, Connecticut; Probity Medical Research, Waterloo, Ontario, Canada.
authors: Bruce E
authors: BE
authors: Strober
authors: Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark.
authors: Peter R
authors: PR
authors: Hansen
authors: Department of Cardiology, Copenhagen University Hospital Rigshospitalet, The Heart Centre, Copenhagen, Denmark.
authors: Ole
authors: O
authors: Ahlehoff
authors: Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark; Department of Dermato-Allergology, Herlev and Gentofte Hospital, Hellerup, Denmark.
authors: Alexander
authors: A
authors: Egeberg
authors: Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island.
authors: Abrar A
authors: AA
authors: Qureshi
authors: Pfizer location in Collegeville, Collegeville, Pennsylvania.
authors: Debbie
authors: D
authors: Robertson
authors: Pfizer location in New York, New York, New York.
authors: Hernan
authors: H
authors: Valdez
authors: Pfizer location in Groton, Groton, Connecticut.
authors: Huaming
authors: H
authors: Tan
authors: Pfizer location in Groton, Groton, Connecticut.
authors: Robert
authors: R
authors: Wolk
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D015897:Comorbidity; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology; D008875:Middle Aged; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011565:Psoriasis / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D011758:Pyrroles / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D002097:C-Reactive Protein; D002784:Cholesterol; D006442:Glycated Hemoglobin; D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D014280:Triglycerides; C479163:tofacitinib
keywords: cardiovascular outcomes; cardiovascular risk factors; major adverse cardiovascular events psoriasis; tofacitinib