Tofacitinib on par with TNFi in rheumatoid arthritis

Tofacitinib demonstrates similar physician- and patient-reported effectiveness to tumour necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA), according to a study.

Using real-world data from the Ontario Best Practices Research Initiative (OBRI), the authors evaluated physician- and patient-reported effectiveness of TNFi relative to tofacitinib. A total of 419 patients enrolled in the OBRI who were treated with the study drugs between 2014 and 2019 were analysed.

Participants had to have physician- and patient-reported effectiveness outcome data, including Clinical Disease Activity Index (CDAI) and RA Disease Activity Index (RADAI), available at treatment initiation and 6 months later. The authors estimated propensity scores for covariates to deal with confounding by indication.

Of the patients, 226 initiated a TNFi and 193 tofacitinib, with a mean disease duration of 8.0 and 12.6 years, respectively. Compared to patients in the tofacitinib group, those in the TNFi group were less likely to have used any biologics (21.7 percent vs 67.9 percent).

The proportion of patients in CDAI low disease activity (LDAI)/remission at 6 months was 36.7 percent in the TNFi group and 33.2 percent in the tofacitinib group.

The generalized linear mixed models, adjusted for propensity score quantile, showed no between-group difference in CDAI LDA/remission (odds ratio [OR], 0.85, 95 percent confidence interval [CI], 0.51‒1.43) and RADAI coefficient (OR, 0.48, 95 percent CI, ‒0.18 to 1.14).

“Tofacitinib is an oral, small-molecule drug used for RA treatment and is one of several alternative treatments to TNFi,” the authors said.