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Pfizer overhauls Xeljanz study over concerns of increased risk of pulmonary embolism and death

Published on 21/02/19 at 10:41am

Pfizer is set to overhaul the dosing groups in its ongoing study of Xeljanz (tofacitinib) after an evaluation from a Rheumatology Data Safety Monitoring Board (DSMB) highlighted safety concerns in the higher of the two doses.

The Board identified a higher risk of pulmonary embolism in patients taking 10mg twice daily than in patients in the tumour necrosis factor inhibitor (TNFi) control group, prompting Pfizer to announce plans to transfer these patients to the lower 5mg twice daily dosing group. Mortality rates in the 10mg group were also higher compared to the TNFi plus 5mg group.

Designed to evaluate the safety of Xeljanz compared to TNFi therapies with a specific focus on cardiovascular event risk, the study is comprised of participants of at least 50 years of age, all of whom started on stable doses of background methotrexate.

“The DSMB stated it firmly believes that the risk-benefit profile of tofacitinib 5 mg twice daily in comparison to the TNFi group remains appropriately balanced in this study. We will work with the FDA and other regulatory agencies to review the full results upon completion of this study,” Pfizer said.

Xeljanz is currently approved by the FDA in its 5mg twice daily form for the treatment of adult patients with moderate to severe rheumatoid arthritis. Sales of the drug shot up 32% to generate $1.77 billion for Pfizer last year.

Matt Fellows

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