The results showed that rheumatologists were impressed by the efficacy results, saw safety as being similar to anti-TNF drugs, and mostly saw tofacitinib currently as a drug they would use when RA patients don’t respond to an anti-TNF agent. "For physicians, it boils down to their comfort with the safety profile," she said in an interview, and they think safety is still a little uncertain.
Although Dr. Borde conceded that "patients are wary of injections" and that oral dosing is an attractive option for many patients, physician uncertainty about safety will generally trump that. "I think safety concerns will drive caution in using tofacitinib," at least during the first couple of years on the market, until a higher comfort level is reached. It’s likely that in an effort to stimulate interest in the drug, Pfizer will price it aggressively, at a small but significant discount to anti-TNF drugs. But even a cost savings probably won’t be enough early on to knock the anti-TNFs from their established RA perch, she said.
Dr. Kremer said that he has received research support from and has been a consultant to Pfizer and several other drugs companies. Dr. McInnes said that he has received research support from and has been a consultant to and speaker for Pfizer and several other drug companies. Dr. Fleischmann said that he has received research support from and has been a consultant to Pfizer and several other drug companies. Dr. Borde said that she had no disclosures.
*New information about Dr. Borde's title has been added to this story.