• Emre Bilgin, Furkan Ceylan, Emine Duran, Bayram Farisoğullari, Ertuğrul Çağri Bölek, Gözde Kübra Yardimci, Levent Kiliç, Alİ Akdoğan, Ömer Karadağ, Şaziye Şule Apraş Bilgen, Sedat Kiraz, Ali İhsan Ertenli, and Umut Kalyoncu.
• Division of Rheumatology, Department of Internal Medicine, Medical School of Hacettepe University, Ankara, Turkey
• Turk J Med Sci. 2021 Feb 26; 51 (1): 297308297-308.

Background/AimTo assess the real-life efficacy, retention rate, and safety data of tofacitinib in rheumatoid arthritis (RA) patients.Materials And MethodsWe 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.ResultsTwo 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.ConclusionTofacitinib is effective as monotherapy or in combination with csDMARDs. It is a well-tolerated treatment option in Turkish RA patients.This work is licensed under a Creative Commons Attribution 4.0 International License.

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