LAUSR

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.