Tofacitinib Versus Non-Tumor Necrosis Factor Biologics for Patients With Active Rheumatoid Arthritis

Nakamura, Yukio; Suzuki, Takehiko; Yamazaki, Hideshi; Kato, Hiroyuki

doi:10.5606/archrheumatol.2018.6366

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…In 40 studies, patients showed an inadequate response to different types of csDMARD and bDMARD therapies , in 5 articles, patients were naïve to csDMARDs [51][52][53][54][55], from which 4 to MTX [51][52][53][54], 1 study did not give restrictions regarding previous medication [56], and 4 studies did not include information about the treatment history [57][58][59]. All JAK inhibitors approved for RA patients were included: tofacitinib appears in 16 [11][12][13][14][15][16][17][18][19][20][21][22][23]51,54,57], baricitinib in 8 [24][25][26][27][28][29][30]55,60], upadacitinib in 9 [31][32][33][34][35][36][37][38]52], filgotinib in 7 …”

Section: Description Of the Studiesmentioning

confidence: 99%

“…All JAK inhibitors approved for RA patients were included: tofacitinib appears in 16 [11][12][13][14][15][16][17][18][19][20][21][22][23]51,54,57], baricitinib in 8 [24][25][26][27][28][29][30]55,60], upadacitinib in 9 [31][32][33][34][35][36][37][38]52], filgotinib in 7 [39][40][41][42]53,58], peficitinib in 5 [43][44][45][46]56], decernotinib in 3 articles [47][48][49], and both ritlecitinib [50] and itacitinib [59] were investigated in 1 study. In 14 studies, pa...…”

Section: Description Of the Studiesmentioning

confidence: 99%

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Janus Kinase Inhibitors Improve Disease Activity and Patient-Reported Outcomes in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of 24,135 Patients

Tóth

Juhász

Szabó

et al. 2022

IJMS

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Pain, fatigue, and physical activity are major determinants of life quality in rheumatoid arthritis (RA). Janus kinase (JAK) inhibitors have emerged as effective medications in RA and have been reported to exert direct analgesic effect in addition to reducing joint inflammation. This analysis aims to give an extensive summary of JAK inhibitors especially focusing on pain and patient reported outcomes (PRO). MEDLINE, CENTRAL, Embase, Scopus, and Web of Science databases were searched on the 26 October 2020, and 50 randomized controlled trials including 24,135 adult patients with active RA met the inclusion criteria. JAK inhibitors yielded significantly better results in all 36 outcomes compared to placebo. JAK monotherapy proved to be more effective than methotrexate in 9 out of 11 efficacy outcomes. In comparison to biological disease-modifying antirheumatic drugs, JAK inhibitors show statistical superiority in 13 of the 19 efficacy outcomes. Analgesic effect determined using the visual analogue scale and American College of Rheumatology (ACR) 20/50/70 response rates was significantly greater in the JAK group in all comparisons, and no significant difference regarding safety could be explored. This meta-analysis gives a comprehensive overview of JAK inhibitors and provides evidence for their superiority in improving PROs and disease activity indices in RA.

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Section: Description Of the Studiesmentioning

confidence: 99%

Section: Description Of the Studiesmentioning

confidence: 99%

Janus Kinase Inhibitors Improve Disease Activity and Patient-Reported Outcomes in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of 24,135 Patients

Tóth

Juhász

Szabó

et al. 2022

IJMS

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“…The introduction of tsDMARDs provides an innovative approach to the treatment of RA. Tofacitinib is the first oral Janus kinase (JAK) inhibitor that has been shown to have greater efficacy than csDMARDs ( Kremer et al, 2013 ), and comparable efficacy and safety profile to bDMARDs in moderate-to-severe RA patients ( van Vollenhoven et al, 2012 ; Lee and Bae, 2016 ; Nakamura et al, 2018 ). In Taiwan, intra-class bDMARD switching reimbursement is allowed only for patients who demonstrate an adequate response to their current bDMARD treatment but are intolerant to its side effects or wish to reduce the administration frequency of their current agent.…”

Section: Introductionmentioning

confidence: 99%

Switching and Discontinuation Pattern of Biologic Disease-Modifying Antirheumatic Drugs and Tofacitinib for Patients With Rheumatoid Arthritis in Taiwan

Chang

Hsin³

et al. 2021

Front. Pharmacol.

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Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease characterized by persistent joint synovial inflammation and swelling, leading to cartilage damage and bone erosion. This retrospective, longitudinal study is to evaluate the treatment patterns of biologic-naïve RA patients receiving index biologic disease-modifying antirheumatic drug (bDMARD) and tofacitinib by the data of Taiwan National Healthcare Insurance Claims and the Death Registry between 2012 and 2017. Drug survival and treatment patterns were determined by investigating the occurrence of switching and discontinuation from index treatment. At baseline, 70.0% of patients used tumor necrosis factor inhibitors (TNFi) bDMARD with the majority taking etanercept (27.0%) or adalimumab (26.2%). During the follow-up period, 40.0% (n = 3,464) of index users switched (n = 1,479) or discontinued (n = 1,985) the treatment with an average incidence rate of 0.18 per patient-year. Among the six index treatment groups, drug survival was the lowest for adalimumab and highest for tocilizumab. When compared with etanercept, only adalimumab had a higher cumulative probability of switching/discontinuation (adjusted HR = 1.17, 95% CI: 1.08–1.28), whereas golimumab, non-TNFi bDMARDs and tofacitinib were significantly less probable to switch or discontinue. For patients switching the index treatment, tocilizumab (31.2%) and tofacitinib (23.4%) were the main regimens being switched to. In addition, 48.2% of patients who discontinued the index treatment received further retreatment, and 63.8–77.0% of them were retreated with same agent. In conclusion, this population-based study found that TNFi were the preferred agents as the index treatments during 2012–2017. Non-TNFi and tofacitinib were more common second-line agents being switched to. Nearly half of discontinued patients received retreatment, with a majority receiving the same agent.

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“…Extensive data from clinical trials confirm the efficacy of tofacitinib used in monotherapy and in combination with a synthetic DMARD, both in the population of patients who have not been previously treated with DMARDs, and in patients with no response to either synthetic or biological DMARDs. The therapeutic effect of tofacitinib is comparable to the efficacy of biologic drugs including TNF-α inhibitors and drugs with a different mechanism of action [18, 19]. Good clinical response to treatment was also demonstrated in our retrospective observational study conducted in the setting of daily clinical practice.…”

Section: Discussionmentioning

confidence: 53%

Tofacitinib in the treatment of active rheumatoid arthritis – single-centre experience

Madej¹,

Woytala²,

Frankowski³

et al. 2019

Reumatologia

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ObjectivesTo assess the efficacy and safety profile of tofacitinib taken orally at a dose of 10 mg/day in patients with severe active rheumatoid arthritis (RA).Material and methodsThe retrospective observational study included 10 patients (6 women and 4 men) with RA treated with tofacitinib. All the patients had high disease activity (DAS28 [ESR] > 5.1), despite therapy with two synthetic disease-modifying antirheumatic drugs (DMARDs). Before the initiation of treatment, routine laboratory tests were performed, and disease activity was assessed in all the subjects.ResultsThe mean age of the patients in the study group was 58.18 years (43–67). The average duration of RA was 9.9 years (2–24). The mean baseline value of DAS28 (ESR) was 6.37. Tofacitinib was used in combination with a conventional DMARD in all study subjects: with methotrexate in the majority of patients, and with leflunomide and an antimalarial drug in three patients. The mean duration of therapy with tofacitinib was 7.57 months (3.9–10.8). A significant decrease in the disease activity was observed (p < 0.05). A reduction in DAS28 (ESR) score was seen already after the first month of therapy, and the trend was maintained during subsequent months of follow-up. The mean value of DAS28 (ESR) after 6 months was 2.78. A slight increase in the serum concentration of HDL cholesterol was observed during treatment. In one patient symptoms of chronic upper respiratory tract infection led to discontinuation of the drug. The observed adverse events were of mild/moderate degree.ConclusionsThe results of our retrospective observational study conducted in the setting of daily clinical practice confirm a good clinical response to tofacitinib. Despite the observed adverse effects, in the light of the available data tofacitinib demonstrates a favourable safety profile. JAK kinase inhibitors – a new class of drugs – will enable a wider population of patients to achieve remission or low disease activity.

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Tofacitinib Versus Non-Tumor Necrosis Factor Biologics for Patients With Active Rheumatoid Arthritis

Abstract: Tofacitinib was well tolerated in active RA patients and exerted effects comparable to those of non-TNF biologics.

Cited by 4 publications

References 9 publications

Janus Kinase Inhibitors Improve Disease Activity and Patient-Reported Outcomes in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of 24,135 Patients

Janus Kinase Inhibitors Improve Disease Activity and Patient-Reported Outcomes in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of 24,135 Patients

Switching and Discontinuation Pattern of Biologic Disease-Modifying Antirheumatic Drugs and Tofacitinib for Patients With Rheumatoid Arthritis in Taiwan

Tofacitinib in the treatment of active rheumatoid arthritis – single-centre experience

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