The findings of a double-blind, withdrawal phase III study, published in Lancet, have reported the safety and efficacy of tofacitinib in managing patients with polyarticular course juvenile idiopathic arthritis (JIA). The study was carried out at 64 centers of the Paediatric Rheumatology International Trials Organisation and Pediatric Rheumatology Collaborative Study Group networks across 14 countries enrolled subjects with polyarticular course JIA aged between 2 years to <18 years. Evaluation of 142 subjects by week 44 showed that the flare rate was significantly lower with subjects who received tofacitinib (29%) than with placebo (53%, P=0·0031).
JIA is a heterogeneous group of diseases with unknown etiology and onset noted prior to the age of 16 years. The currently preferred therapeutic choices, as per the guidelines, for polyarticular course JIA and systemic JIA are conventional synthetic and biological disease-modifying antirheumatic drugs (DMARDs).
Tofacitinib has been approved by both the European Medicines Agency (EMA) and FDA for the treatment of polyarticular JIA and juvenile psoriatic arthritis. Newer oral therapies like tofacitinib may serve as an effective treatment of JIA with the polyarticular course and are ideal for children and adolescent patients who prefer oral medications over painful injections.