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2017 ; 12
(5
): e0177057
Nephropedia Template TP
gab.com Text
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Efficacy and safety at 24 weeks of daily clinical use of tofacitinib in patients
with rheumatoid arthritis
#MMPMID28472115
Iwamoto N
; Tsuji S
; Takatani A
; Shimizu T
; Fukui S
; Umeda M
; Nishino A
; Horai Y
; Koga T
; Kawashiri SY
; Aramaki T
; Ichinose K
; Hirai Y
; Tamai M
; Nakamura H
; Terada K
; Origuchi T
; Eguchi K
; Ueki Y
; Kawakami A
PLoS One
2017[]; 12
(5
): e0177057
PMID28472115
show ga
OBJECTIVE: We evaluated the efficacy and safety of tofacitinib in patients with
rheumatoid arthritis (RA) in a real-world setting. METHODS: Seventy consecutive
patients, for whom tofacitinib was initiated between November 2013 and May 2016,
were enrolled. All patients fulfilled the 2010 ACR/EULAR classification criteria
for RA. All patients received 5 mg of tofacitinib twice daily and were followed
for 24 weeks. Clinical disease activity indicated by disease activity score
(DAS)28-ESR, the simplified disease activity index, and the clinical disease
activity index as well as adverse events (AEs) were evaluated. Statistical
analysis was performed to determine which baseline variables influenced the
efficacy of tofacitinib at 24 weeks. RESULTS: Fifty-eight patients (82.9%)
continued tofacitinib at 24 weeks. Clinical disease activity rapidly and
significantly decreased, and this efficacy continued throughout the 24 weeks:
i.e., DAS28-ESR decreased from 5.04 ± 1.33 at baseline to 3.83 ± 1.11 at 4 weeks
and 3.53 ± 1.17 at 24 weeks (P<0.0001, vs. baseline). 15 AEs including 5 herpes
zoster infection occurred during tofacitinib treatment. The efficacy of
tofacitinib was not changed in patients without concomitant use of methotrexate
(MTX) or patients whose treatment with tocilizumab (TCZ) failed. Multivariable
logistic analysis showed that the number of biologic DMARDs (bDMARDs) previously
used was independently associated with achievement of DAS-low disease activity.
CONCLUSIONS: Our present study suggests that tofacitinib is effective in
real-world settings even without concomitant MTX use or after switching from TCZ.
Our results also suggest that its efficacy diminishes if started after use of
multiple bDMARDs.
|Aged
[MESH]
|Antirheumatic Agents/adverse effects/*therapeutic use
[MESH]
|Arthritis, Rheumatoid/*drug therapy
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Piperidines/adverse effects/*therapeutic use
[MESH]
|Pyrimidines/adverse effects/*therapeutic use
[MESH]
free
free
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