Efficacy and Baseline Predictors of Tofacitinib Response in Patients with Rheumatoid Arthritis at a Private Tertiary Care Hospital in Pakistan

Maryam Ahmed; Shahida Perveen; Saira Yaseen; Maimoona Firdus; Saba Samreen; Haris Gul; Babur Salim; Amjad  Nasim

doi:10.51253/pafmj.v76iSUPPL-1.13219

Authors

Maryam Ahmed Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan
Shahida Perveen Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan
Saira Yaseen Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan
Maimoona Firdus Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan
Saba Samreen Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan
Haris Gul Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan
Babur Salim Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan
Amjad Nasim Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-1.13219

Keywords:

Tofacitinib, Efficacy, BMI, Serology, Inflammatory, Rheumatoid Arthritis

Abstract

Objective: To analyze the efficacy of Tofacitinib and predictors of response in Rheumatoid Arthritis patients

Study Design: Prospective longitudinal study

Place and Duration of Study: Rheumatology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan, from Mar to Sep 2024.

Methodology: The study included 76 adult RA patients (75 females and 1 male), who were advised to take Tofacitinib. We recorded the DAS-28 ESR at baseline and after 3 months and noted patient demographics, BMI, serology, and concomitant DMARD use. The primary outcome was remission/low disease activity (DAS-28≤3.2) at 3 months. DAS-28 levels were compared by Wilcoxon test. Treatment outcome was categorized as a good response and poor response. Predictors of treatment response were analyzed using univariate logistic regression analysis.

Results: The median age of patients was 50.50(IQR 57.00 - 45.25) years. Median RA duration was 9.00(IQR 15.00 – 6.00) years with 60(78.95%) patients being seropositive. Conventional DMARD was continued in combination with Tofacitinib in 55(72.4%) patients. Only 11(14.5%) patients achieved the treatment target. Tofacitinib therapy significantly reduced DAS-28 from baseline of 5.64 (IQR 5.99 - 5.08), to 3.99±0.76 at 3 months (p-value <0.001). Lower baseline DAS-28 predicted an effective treatment response (OR 4.13, 95%CI 1.07-16.03, p-value 0.03). Tofacitinib monotherapy predicted a good response in comparison to Tofacitinib combination with conventional DMARDs (OR 4.00, 95% CI1.06-14.96, p-value 0.03). Baseline BMI, inflammatory markers, and serology did not have an impact on treatment response.

Conclusion: Tofacitinib therapy significantly reduced DAS-28 ESR at 3 months with baseline predictive factors such as BMI and ....

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Author Biography

Shahida Perveen, Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi Pakistan

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