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Effectiveness and baseline predictive factors for Tofacitinib response in rheumatoid arthritis in a real-world setting: A national multicenter study


MOJ Orthopedics & Rheumatology
Vinicki JP,1  Gomez R,2 Maliandi MR,3 Velasco Zamora JL,4 Malvano YS,5 Cusa MA,6 Gamba MJ,2 Got J,7 Gut O,8 Paris V,9 Spinetto MA,8 Mariasch NC,8 Abalo AI,10 Estevez AJ10

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Abstract

  1. Background:Evidence of effectiveness and safety of tofacitinib (TOF) in the real-world setting in Latin America is currently limited and crucial to complement long-term extension data from randomized controlled trials.
  2. Methods:Patients initiated on TOF between 2014 and 2020 with RA (ACR/EULAR, 2010 criteria)were analyzed. The primary end point at month 3 was remission measured by DAS28-ESR. Secondary end points includedprognostic factors for remission at 3 months and of monotherapy at month 12.
  3. Results:Overall, 134 RA patients were analyzed. Remission was achieved in 38.06% at month 3. In univariate analysis, persistent disease activity at 3 months was observed in those patients with longer duration of disease, structural radiological damage, higher baseline DAS28-ESR and greater frequency in previous use of bDMARD. In multivariate analysis, previous use of bDMARD was significantly associated with a decrease in the probability of remission at 3 months. At 12 months, TOF monotherapy group was elderly (p = 0.009) and had a trend for lower frequency of anti-CCP. Treatment persistence was 94.78% at 3 months, 82.84% at 6 months and 66.42% at 12 months.
  4. Conclusions:Clinical remission at 3 months was negatively associated with prior bDMARD and poor prognostic factors. TOF monotherapy at 12 months was more common in elderly patients.

Keywords

: tofacitinib, Janus kinase inhibitor, rheumatoid arthritis, real-world settings, daily clinical practice

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