Discontinuation of tofacitinib after achieving low disease activity in patients with rheumatoid arthritis: a multicentre, observational study
| العنوان: | Discontinuation of tofacitinib after achieving low disease activity in patients with rheumatoid arthritis: a multicentre, observational study |
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| المؤلفون: | Koichi Amano, Satoshi Kubo, Kanako Iwata, Hayato Nagasawa, Yoshiya Tanaka, Eiichi Suematsu, Shuji Nagano, Shigeto Tohma, Kunihiro Yamaoka |
| المصدر: | Rheumatology. 56:1293-1301 |
| بيانات النشر: | Oxford University Press (OUP), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Time Factors, Arthritis, Rheumatoid, Disease activity, 03 medical and health sciences, 0302 clinical medicine, Piperidines, Rheumatology, Internal medicine, medicine, Clinical endpoint, Humans, Rheumatoid factor, Pyrroles, Pharmacology (medical), In patient, Prospective Studies, 030212 general & internal medicine, Aged, 030203 arthritis & rheumatology, Tofacitinib, business.industry, Middle Aged, medicine.disease, Discontinuation, Pyrimidines, Treatment Outcome, Withholding Treatment, Antirheumatic Agents, Rheumatoid arthritis, Disease Progression, Female, Observational study, business |
| الوصف: | Objective To determine whether tofacitinib can be discontinued in patients with RA who achieve low disease activity (LDA). Methods RA patients with LDA after tofacitinib treatment in a phase III and long-term extension study were enrolled in this multicentre, non-randomized, open, prospective, observational study. The decision of discontinuation or continuation of tofacitinib was determined based on patient-physician decision making with informed consent. The primary endpoint was the proportion of patients who remained tofacitinib-free at post-treatment week 52. Clinical outcome was compared between those who continued and those who discontinued tofacitinib. The last observation carried forward method was used for patients who could not discontinue tofacitinib before week 52. Results Of 64 patients, 54 discontinued and 10 continued tofacitinib therapy. At post-treatment week 52, 20 of the 54 patients (37%) of the discontinuation group remained tofacitinib-free without disease flare. Disease activity at post-treatment week 52 was higher in the discontinuation group than the continuation group. Among the discontinuation group, the RF titre at baseline was significantly lower in patients who remained tofacitinib-free than those who did not (40 vs 113 U/ml). In fact, a higher proportion of patients with lower RF remained tofacitinib-free at week 52 compared with those with higher RF at baseline. In patients who could not achieve tofacitinib-free status, re-initiation of tofacitinib or other biologics improved disease activity. Conclusion It is possible to discontinue tofacitinib without flare in about a third of patients with RA. A low RF predicts maintenance of LDA after discontinuation of tofacitinib. |
| تدمد: | 1462-0332 1462-0324 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e377198c44216cb4ce7a12e8f22862ce https://doi.org/10.1093/rheumatology/kex068 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e377198c44216cb4ce7a12e8f22862ce |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14620332 14620324 |
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