Tofacitinib treatment is better after conventional DMARDs in RA patients

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A recent study published in Clinical and Experimental Rheumatology reported that tofacitinib may be a successful treatment option after traditional DMARDs than after the failure of biologic therapy in RA patients.1

The retrospective cohort study carried out by Moreno et al. at a center for RA in Colombia involved 152 Colombian (Latin-American) patients who received tofacitinib treatment. Eighty-five (55.9%) patients received the drug as first-line treatment following failure with conventional DMARDs and as second-line by 67 patients (44.1%) following failure with biologic DMARDs.

Comparative examination of therapeutic response revealed a decrease in DAS28 at 3, 6, and 12 months in both the trial groups and the percentage of achieving remission was higher in first-line patients (45% vs 23%). Baseline DAS28 was found to be significantly associated with the treatment response at 12 months. In second-line patients, no association was found between response to tofacitinib and the number of biologic DMARDs previously received.

Charles-Schoeman et al. have reported the efficacy of tofacitinib in RA patients who were naïve or had shown inadequate response towards bDMARD.2 Similar findings were noted by Rivero et al. and the authors concluded that tofacitinib is a successful treatment of choice for patients with RA who have failed conventional DMARDs and biologic therapy, and it may be more beneficial as a first-line treatment.3

The current study authors, Santos-Moreno et al. concluded that, regardless of the number of prior biologics utilized, tofacitinib is efficacious after both conventional DMARDs and biological therapy.

References

  1. Santos-Moreno P, Martinez S, Ibata L, Villarreal L, Rodríguez-Florido F, Rivero M, Rojas-Villarraga A, Galarza-Maldonado C. Is Tofacitinib Effectiveness in Patients with Rheumatoid Arthritis Better After Conventional Than After Biological Therapy? – A Cohort Study in a Colombian Population. Biologics. 2022 Jul 13;16:107-117.
  2. Charles-Schoeman C, Burmester G, Nash P, Zerbini CA, Soma K, Kwok K, Hendrikx T, Bananis E, Fleischmann R. Efficacy and safety of tofacitinib following inadequate response to conventional synthetic or biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2016 Jul;75(7):1293-301.
  3. Rivero W, Ibata L, Martinez S, Rojas-Villarraga A, Santos-Moreno P. Ab0275 Tofacitinib Effectiveness in Patients with Rheumatoid Arthritis After Conventional or Biological Therapy – It Real Role in Different Lines of Treatment. Annals of the Rheumatic Diseases. 2021 Jun 1;80(Suppl 1):1163–1163.