Oral Janus Kinase Inhibitor for the Treatment of Rheumatoid Arthritis: Tofacitinib

Han Ni,Soe Moe,Aung Htet,Kay Thi Myint

doi:10.1155/2013/357904

Abstract

Since the introduction of immune modulators in the treatment of rheumatoid arthritis (RA), there has been hope that orally effective biologic agents would be developed. Tofacitinib, a Janus kinase inhibitor, has become the first oral biologic to receive approval for use in active RA patients. This paper reviews the efficacy and safety profile of Tofacitinib at dosages of 5 mg and 10 mg twice daily. Remarkable improvement in terms of ACR 20 response and HAQ-DI score was noted at month 3 and month 6. DAS 28-4 ESR < 2.6 achievement was noticeably obvious at month 6 for both dosages. No significant serious adverse events, serious infections, neutropenia, or anaemia were observed compared to placebo. In fact, Tofacitinib 5 mg was even found to have significant protective effect of anaemia in the meta-analysis (P = 0.004). Tofacitinib has a noticeable efficacy in controlling disease activity in RA with a manageable safety profile. However, longer studies are needed for its long-term safety profile.

Highlights

Rheumatoid arthritis (RA) is a common immune-mediated systemic disorder, characterized by inflammatory polyarthritis affecting synovium of joints, tendons, and extra-articular sites
Tofacitinib has a noticeable efficacy in controlling disease activity in rheumatoid arthritis (RA) with a manageable safety profile
We identified published randomized controlled trials on Tofacitinib in RA patients by searching the PubMed database using the search terms “Tofacitinib” odds ratio (OR) “Janus Kinase inhibitor” AND “Rheumatoid arthritis” AND “randomiz/sed controlled trial.”

Summary

Introduction

Rheumatoid arthritis (RA) is a common immune-mediated systemic disorder, characterized by inflammatory polyarthritis affecting synovium of joints, tendons, and extra-articular sites. It is progressive and leads to joint erosions and deformities, causing premature mortality, functional impairment, and reduced quality of life [1]. The prevalence of RA remains constant at 0.5–1.0% among various population group [2, 3]. The prevalence is generally lower in developing countries [4]. In 2005, 1.5 million adults of more than 18 years (0.6%) in the United States were estimated to have RA [5]. HLA DRB1 allele is the major genetic risk factor of RA around the world [2]

Results

Discussion

Conclusion