The 6-month drug survival rate in patients withrheumatoid arthritis treated with tofacitinib

The 6-month drug survival rate in patients withrheumatoid arthritis treated with tofacitinib

Aim: Rheumatoid arthritis (RA) is a progressive, inflammatory, autoimmune disease that particularly affects the joints. Tofacitinib is the first oral Janus kinase inhibitor approved for RA treatment. We aimed to analyze the 6-month drug survival rate and factors affecting the discontinuation of tofacitinib in RA patients.Materials and Methods: Age, gender, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) levels, whether to continue treatment tofacitinib, if treatment is not continued what treatment is applied, use of biological agent before tofacitinib treatment were retrospectively recorded from the patient data.Results: 30 RA patients included in the study (29 female, 1 male) with a mean age of 50.5 ± 11.3 years. At the 6th month of treatment of tofacitinib, the drug survival rates were 50%. There was no significant difference between CCP positive and negative patients as well as between RF positive and negative patients in terms of drug survival rates (p = 0.92 and p = 0.90, respectively). The drug survival rates were alike in tofacitinib monotherapy and combined therapy of tofacitinib with any conventional DMARD (p = 0.36). The tofacitinib survival rates were similar in biologically naïve patients and in patients who had received at least one previous biological DMARD (p = 0.70).Conclusion: Half of the RA patients receiving tofacitinib treatment continue their treatment at the 6th month. The drug survival rate was not associated with co-treatment with conventional DMARD, auto-antibody positivities, and previously used biological DMARD therapy. These findings support that tofacitinib shows similar efficacy when used as combined or monotherapy, in seronegative or seropositive patients, and in biologic resistant or naive patients.

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  • 1. Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res 2002;3:265-72. 2. van der Linden MP, le Cessie S, Raza K, et al. Longterm impact of delay in assessment of patients with early arthritis. Arthritis Rheum 2010;62:3537-46.
  • 3. Moura CS, Abrahamowicz M, Beauchamp ME, et al. Early medication use in new-onset rheumatoid arthritis may delay joint replacement: results of a large population-based study. Arthritis Res Ther 2015;17:197.
  • 4. Raza K, Stack R, Kumar K, et al. Delays in assessment of patients with rheumatoid arthritis: variations across Europe. Ann Rheum Dis 2011;70:1822-5.
  • 5. Deane KD. Can rheumatoid arthritis be prevented? Best Pract Res Clin Rheumatol 2013;27:467-85.
  • 6. Smolen JS, Aletaha D, Barton A, et al. Rheumatoid arthritis. Nat Rev Dis Primers 2018;4:18001.
  • 7. Sanmartí R, García-Rodríguez S, Álvaro-Gracia JM, et al. 2014 update of the Consensus Statement of the Spanish Society of Rheumatology on the use of biological therapies in rheumatoid arthritis. Reumatol Clin 2015;11:279-94.
  • 8. Van Doornum S, McColl G, Wicks IP. Tumour necrosis factor antagonists improve disease activity but not arterial stiffness in rheumatoid arthritis. Rheumatology (Oxford) 2005;44:1428-32.
  • 9. O’Shea JJ, Laurence A, McInnes IB, et al. Back to the future: oral targeted therapy for RA and other autoimmune diseases. Nat Rev Rheumatol 2013;9:173–82.
  • 10. Smolen JS, Landewe R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological diseasemodifying antirheumatic drugs: 2016 update. Ann Rheum Dis 2017;76:960–77.
  • 11. Venkatesha SH, Dudics S, Acharya B, et al. Cytokinemodulating strategies and newer cytokine targets for arthritis therapy. Int J Mol Sci 2014;16:887-906.
  • 12. Hodge JA, Kawabata TT, Krishnaswami S, et al. The mechanism of action of tofacitinib—an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. Clin Exp Rheumatol 2016;34:318–28.
  • 13. Caporali R, Zavaglia D. Real-world experience with tofacitinib for the treatment of rheumatoid arthritis. Clin Exp Rheumatol 2019;37:485-95.
  • 14. Strand V, Lee EB, Fleischmann R, et al. Tofacitinib versus methotrexate in rheumatoid arthritis: patientreported outcomes from the randomised phase III ORAL Start trial. RMD Open 2016;2:e000308.
  • 15. Harnett J, Gerber R, Gruben D, et al. Evaluation of Real-World Experience with Tofacitinib Compared with Adalimumab, Etanercept, and Abatacept in RA Patients with 1 Previous Biologic DMARD: Data from a U.S. Administrative Claims Database. J Manag Care Spec Pharm 2016;22:1457-71.
  • 16. Iwamoto N, Tsuji S, Takatani A, et al. Efficacy and safety at 24 weeks of daily clinical use of tofacitinib in patients with rheumatoid arthritis. PLoS One 2017;12:e0177057.
  • 17. Smith T, Harnett J, Gruben D, et al. Real-World Experience with Tofacitinib Versus Adalimumab and Etanercept in Biologic-Naive Patients with RA Previously Treated with Methotrexate: Data from a US Administrative Healthcare Insurance Claims Database [abstract]. Arthritis Rheumatol 2017;69.
  • 18. Reed GW, Gerber RA, Shan Y, et al. Real-World Comparative Effectiveness of Tofacitinib and Tumor Necrosis Factor Inhibitors as Monotherapy and Combination Therapy for Treatment of Rheumatoid Arthritis. Rheumatol Ther 2019.
  • 19. Mori S, Yoshitama T, Ueki Y. Tofacitinib Therapy for Rheumatoid Arthritis: A Direct Comparison Study between Biologic-naïve and Experienced Patients. Intern Med 2018;57:663-70.
  • 20. Pope JE, Keystone E, Jamal S, et al. Persistence of Tofacitinib in the Treatment of Rheumatoid Arthritis in Open-Label, Long-Term Extension Studies up to 9.5 Years. ACR Open Rheumatol 2019;1:73-82.
  • 21. Pope J, Bessette L, Jones N, et al. Experience with tofacitinib in Canada: patient characteristics and treatment patterns in rheumatoid arthritis over 3 years. Rheumatology (Oxford) 2020;59:568-74.
  • 22. Bird P, Littlejohn G, Butcher B, et al. Real-world evaluation of effectiveness, persistence, and usage patterns of tofacitinib in treatment of rheumatoid arthritis in Australia. Clin Rheumatol 2020.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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