Potentially ‘life changing’ arthritis drug listed on PBS

Matt Woodley

29/04/2019 2:49:38 PM

Tofacitinib will be listed despite lingering concerns related to an increased risk of blood clots and potentially death when taken in high doses.

Hands with arthritis.
Tofacitinib will be available for $40.30 per script.

Tofacitinib (sold as Xeljanz), is already available on the Pharmaceutical Benefits Scheme (PBS), but will be extended to include treatment of patients with psoriatic arthritis, saving them up to $16,000 per year.
More than 4800 patients are expected to benefit from the subsidy, which will allow them to access the medicine for $40.30 per script, or $6.50 with a concession card.
The medication works by blocking the activation of parts of the immune system that cause inflammation in the joints; however, it has also been linked with potentially fatal side effects.
Dr Morton Rawlin, Chair of the RACGP Dermatology Specific Interests network, told newsGP that while there has been some complications related to the use of tofacitinib in some patients, they were limited to cases for which high doses had been prescribed.
‘All of these medications have side effects. They cause immunosuppression and have other specific systemic effects dependent of the particular drug, but when used well they can be life-changing,’ he said.
‘The biggest issue for GPs around this class of drugs is that we actually don’t have access to prescribe them; they’re only available through hospital clinics or the dermatologist or rheumatologist. However, GPs will need to be aware of what side effects to watch for in their patients.
‘It’s not a drug you would commonly use for psoriasis, but it certainly has been used for severe plaque psoriasis and psoriatic arthritis.’
The Therapeutic Goods Administration (TGA) issued a safety alert in March stating it was ‘closely monitoring’ results from an international post-marketing study of the $2.5 billion drug.
Specifically, the US rheumatology Data Safety Monitoring Board (DSMB) found a 10 mg twice-daily dose of tofacitinib results in a ‘statistically and clinically important difference’ in the occurrence of pulmonary embolism, compared with a reduced 5 mg twice-daily dose.

Clarification: Tofacitinib was incorrectly identified as a biologic agent in an earlier version of the story. 

arthritis PBS Pharmaceutical Benefits Scheme psoriatic tofacitinib


Login to comment

Kawasaki   30/04/2019 3:43:49 AM

Xeljanz is not a biologic, this is a mistake. It is quite a small molecule in fact, C16H20N6O