In a nutshell
This study examined how effective tofacitinib (Xeljanz) is as a treatment for early stage rheumatoid arthritis. The authors concluded that tofacitinib treatment on its own or in conjunction with methotrexate (Trexall) can reduce inflammation and can slow disease progression.
Some background
Patients with rheumatoid arthritis (RA) often experience inflammation of the membranes in their joints (known as synovitis), bone damage and a build-up of fluid in the bones called bone marrow edema (BME). If these symptoms are treated early in a patient’s diagnosis it can reduce long-term damage.
Methotrexate is one of the most commonly prescribed drugs for RA. Some patients do not respond well to this treatment and so an alternative is needed. Tofacitinib is a drug that can block the activity of certain enzymes in the body that cause inflammation. It is also known to reduce structural damage in RA patients. It is not clear whether tofacitinib is effective in early RA.
Methods & findings
109 early-stage RA patients were included in this study. They were split into three groups. Group 1 received a combination of tofacitinib and methotrexate. Group 2 received tofacitinib only and group 3 received methotrexate only. The patents received treatment over the course of 12 months. Measurements of synovitis, BME and bone damage were taken at 1, 3, 6 and 12 months.
At 3 months synovitis was lower in group 1 and group 2 than in group 3. At 6 months, BME was decreased in both group 1 and group 2 compared to group 3. The level of bone damage seen was also less in groups 1 and 2 compared to group 3.
The bottom line
This study concluded that treatment with tofacitinib either on its own or in conjunction with methotrexate is more effective than treatment with methotrexate alone in patients with early stage RA.
The fine print
This study was conducted on a small number of patients. A high number of patients reported side effects during the study.
What’s next?
Consult with your physician regarding the treatment options available for rheumatoid arthritis.
Published By :
Annals of the rheumatic diseases
Date :
Jun 01, 2016
