1. Efficacy, retention, and safety of tofacitinib in real-life: Hur-bio monocentric experience
- Author
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Bilgin E, Ceylan F, Duran E, Farisoğullari B, Bölek EÇ, Yardimci GK, Kiliç L, Akdoğan A, Karadağ Ö, Apraş Bilgen ŞŞ, Kiraz S, Ertenli Aİ, and Kalyoncu U
- Subjects
- Antirheumatic Agents administration & dosage, Antirheumatic Agents adverse effects, Drug Therapy, Combination methods, Duration of Therapy, Female, Herpes Zoster diagnosis, Humans, Kaplan-Meier Estimate, Longitudinal Studies, Male, Middle Aged, Outcome and Process Assessment, Health Care, Patient Acuity, Treatment Failure, Turkey epidemiology, Arthritis, Rheumatoid diagnosis, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid epidemiology, Arthritis, Rheumatoid physiopathology, Drug Monitoring methods, Drug Monitoring statistics & numerical data, Piperidines administration & dosage, Piperidines adverse effects, Pyrimidines administration & dosage, Pyrimidines adverse effects
- Abstract
Background/aim: To assess the real-life efficacy, retention rate, and safety data of tofacitinib in rheumatoid arthritis (RA) patients., Materials and Methods: We analyzed all patients registered in the HURBİO database who received at least 1 dose of tofacitinib. Patients who received at least one dose were included in retention analysis; patients with at least 1 control visit were included in efficacy and safety analysis. Factors predicting good response at the last follow-up visit were analyzed by logistic regression analysis. Drug retention rates were calculated using the Kaplan–Meier method and predictors of drug retention were determined by Cox proportional hazard model. Adverse events, reasons for switching, and discontinuation were also determined., Results: Two hundred and forty-seven (210, 85.0% female) patients were included in the study. The median duration of tofacitinib treatment was 10.2 (20.2) [med, (IQR)] months. Two hundred and four (82.6%) patients were included in safety and efficacy analysis; 45.6% of patients were in low-disease activity (LDA) state (DAS28-CRP ≤ 3.2). Predictors of LDA were being biologic-naïve [aOR 2.53 (1.31–4.88); 95% CI] and RF negativity [aOR 2.14 (1.12–4.07); 95% CI]. At 1 year, the overall tofacitinib retention rate was 63.9% with no relevant predicting factor. Response and retention rates of tofacitinib were similar in patients with and without concomitant csDMARDs. Treatment failure was the most common cause of discontinuation. The most common infectious and laboratory adverse events were herpes zoster infection (3.9 per 100 patient-years) and elevation in ALT (x3UNL: 9.7 per 100 patient-years), respectively., Conclusion: Tofacitinib is effective as monotherapy or in combination with csDMARDs. It is a well-tolerated treatment option in Turkish RA patients., Competing Interests: LK, OK, SAB, SK, AIE, and UK received consultancy fees and/or speaker fees from Abbvie, Amgen, Janssen, Novartis, Pfizer, Roche, UCB Pharma. Other authors have no conflict of interest to report., (This work is licensed under a Creative Commons Attribution 4.0 International License.)
- Published
- 2021
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