Background

Psoriasis is often treated with immunomodulatory therapies that can affect the immune response to common antigens. Tofacitinib is an oral Janus kinase inhibitor.

Objective

To characterize the effect of long-term exposure to tofacitinib 10 mg twice daily on T-cell function in psoriasis patients.

Methods

Patients completing at least 3 months' continuous treatment with tofacitinib 10 mg twice daily were vaccinated with T-cell–dependent vaccines (monovalent tetanus toxoid and 13-valent pneumococcal conjugate [PCV-13]). Patients were assessed at baseline (before vaccination) and then again 4 weeks after vaccination. For PCV-13, we evaluated serotype-specific, opsonophagocytic antibody responses, and for tetanus toxoid, we evaluated humoral responses.

Results

Among 60 patients who completed the study, the geometric mean fold rise from baseline for the 13 PCV serotypes at 4 weeks postvaccination varied from 8.3 (serotype 3) to 101.9 (serotype 6A). Similar results were observed for patients with and without lymphopenia at baseline. For tetanus toxoid, 51 (88%) patients had ≥2-fold and 35 (60%) patients had ≥4-fold rise in antibody concentration.

Limitations

There was no placebo control.

Conclusion

Most psoriasis patients who receive tofacitinib can mount satisfactory T-cell–dependent responses to PCV-13 and tetanus vaccines.

中文翻译：

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托法替尼治疗期间中重度牛皮癣患者对肺炎球菌结合疫苗（PCV-13）和破伤风类毒素疫苗的T细胞介导的免疫反应

背景

牛皮癣经常用免疫调节疗法治疗，这种疗法可影响对常见抗原的免疫反应。Tofacitinib是口服Janus激酶抑制剂。

客观的

为了表征牛皮癣患者长期两次每天两次暴露于10 mg托法替尼对T细胞功能的影响。

方法

每天至少两次用托法替尼10 mg完成连续治疗至少3个月的患者，接种了T细胞依赖性疫苗（单价破伤风类毒素和13价肺炎球菌结合物[PCV-13]）。在基线时（接种前）对患者进行评估，然后在接种后4周再次评估患者。对于PCV-13，我们评估了血清型特异性调理吞噬抗体反应，对于破伤风类毒素，我们评估了体液反应。

结果

在完成研究的60位患者中，接种后4周，这13种PCV血清型的几何平均倍数从基线升高，从8.3（3型）到101.9（6A型）。在基线时有和没有淋巴细胞减少症的患者观察到相似的结果。对于破伤风类毒素，抗体浓度上升≥2倍的患者为51（88％），而抗体浓度上升≥4倍的患者为35（60％）。

局限性

没有安慰剂对照。

结论

接受托法替尼治疗的大多数牛皮癣患者可以对PCV-13和破伤风疫苗产生令人满意的T细胞依赖性反应。