In a nutshell
This study reviewed information on the use of tofacitinib (Xeljanz) for the treatment of rheumatoid arthritis (RA). They found that tofacitinib is effective and well-tolerated for patients with RA.
Some background
Tofacitinib (TFB) is a new drug to treat rheumatoid arthritis (RA). It blocks a type of enzyme called Janus Kinases (JAK). JAK enzymes are involved in inflammation. Patients with RA experience pain and swelling in the joints due to excessive inflammation.
There are many drugs to treat RA. However, as RA is a long-term condition, RA medications, also called disease-modified anti-rheumatic drugs (DMARDs) may become less effective over time. The safety and effectiveness of TFB have been established. However, the effectiveness of a drug does not mean it will be used in clinical practice. It is unclear if TFB is successful in real-world medicine.
Methods & findings
This study reviewed published reports on the use of TFB for RA treatment. Studies that analysed the use of TFB in clinical practice were included.
12 studies analyzed the effects of TFB treatment and patient characteristics. Patients treated with TFB tend to have had RA for longer. They also tend to have been exposed to longer treatment with biological (b)DMARDs. TFB is effective as a monotherapy (TFB alone), which agrees with previous clinical trial results. Patients tend to tolerate TFB and continue with treatment.
2 studies suggest that patients that have not been exposed to bDMARDs respond better to TFB. Low disease activity or remission (no symptoms) is more likely in patients treated with TFB that have not taken bDMARDs. The more bDMARDs a patient has taken for RA, the less effective TFB may be. In clinical practice, TFB is well tolerated. The rate for stopping TFB treatment is less than 10%. The rates and types of side effects associated with TFB are similar in clinical practice and in previous clinical trials.
The bottom line
The authors concluded that tofacitinib is well-tolerated and effective in patients with RA in a real-world clinical setting.
The fine print
Pfizer, the manufacturer of tofacitinib, funded this review.
Published By :
Clinical and experimental rheumatology
Date :
Aug 29, 2018
