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Adding tofacitinib to treatment with DMARDs improves pain and function in patients with active RA

Adding tofacitinib to treatment with disease-modifying anti-rheumatic drugs () may help improve symptoms in patients with active (RA). Nonbiologic , including methotrexate, are commonly used to treat RA. However, alone do not always adequately treat the disease.

Tofacitinib is a novel, oral, Janus kinase inhibitor that treats RA. Researchers sought to determine the safety and efficacy of tofacitinib taken in combination with nonbiologic DMRDs.

Patients with inadequately controlled RA (n = 792) despite treatment with nonbiologic DMARDs were randomly assigned to one of four twice-daily treatment sequences: 5 mg of tofacitinib; 10 mg of tofacitinib; placebo advanced to 5 mg of tofacitinib; or placebo advanced to 10 mg of tofacitinib.

The study showed that when used in combination with various nonbiologic DMARDs, tofacitinib, 5 mg and 10 mg twice daily, compared with placebo, rapidly reduced the signs and symptoms of RA and improved physical function. Adverse events included decreases in neutrophil counts, increases in high- and low-density lipoprotein cholesterol level, and small increases in serum creatinine and aminotransaminase levels.

Tofacitinib in Combination With Nonbiologic Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis: A Randomized Trial, Joel Kremer, MD; Zhan-Guo Li, MD, PhD; Stephen Hall, MD; , MD; , MD; Emilio Martin-Mola, MD, PhD; , PhD; , PhD; Gene Wallenstein, PhD; Sriram Krishnaswami, PhD; Samuel H. Zwillich, MD; Tamas Koncz, MD; Richard Riese, MD, PhD; and John Bradley, MD, Ann Intern Med. 2013;159(4):253-261. doi:10.7326/0003-4819-159-4-201308200-00006


Annals of Internal Medicine PDF Table of Contents 20 August 2013, Vol. 159. No. 4

American College of Physicians