title: Oral janus kinase inhibitor for the treatment of rheumatoid arthritis: tofacitinib.
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.
authors: Internal Medicine, SEGi University, No. 9 Jalan Teknologi, Taman Sains Selangor, Kota Damansara, PJU 5, 47810 Petaling Jaya, Selangor, Malaysia.
authors: Han
authors: H
authors: Ni
authors: Soe
authors: S
authors: Moe
authors: Kay Thi
authors: KT
authors: Myint
authors: Aung
authors: A
authors: Htet
references: Clin Rheumatol. 2006 Nov;25(6):778-81
references: 16609823
references: Arthritis Care Res (Hoboken). 2012 May;64(5):625-39
references: 22473917
references: N Engl J Med. 2012 Aug 9;367(6):495-507
references: 22873530
references: Expert Opin Ther Pat. 2008 Jul;18(7):723-738
references: 19578469
references: N Engl J Med. 2013 Jan 10;368(2):161-70
references: 23301733
references: Ann Rheum Dis. 2014 May;73(5):871-82
references: 23599436
references: Immunity. 2012 Apr 20;36(4):503-14
references: 22520844
references: Arthritis Rheum. 2012 Mar;64(3):617-29
references: 21952978
references: Lancet. 2013 Feb 9;381(9865):451-60
references: 23294500
references: Arthritis Rheum. 2012 Jun;64(6):1790-8
references: 22147632
references: Arthritis Rheum. 2012 Apr;64(4):970-81
references: 22006202
references: Arthritis Care Res (Hoboken). 2011 Aug;63(8):1150-8
references: 21584942
references: Curr Opin Pharmacol. 2013 Jun;13(3):426-34
references: 23523202
references: Drug Des Devel Ther. 2012;6:245-50
references: 23055694
references: Ann Rheum Dis. 2010 Jun;69(6):964-75
references: 20444750
references: Clin Exp Rheumatol. 2003 Sep-Oct;21(5 Suppl 31):S179-85
references: 14969073
references: Arthritis Res. 2002;4 Suppl 3:S265-72
references: 12110146
references: Ann Rheum Dis. 2010 Feb;69(2):413-6
references: 19587388
references: N Engl J Med. 2012 Aug 9;367(6):508-19
references: 22873531
references: Curr Opin Rheumatol. 2012 May;24(3):335-41
references: 22357358
references: Arthritis Rheum. 2009 Jul;60(7):1895-905
references: 19565475
references: Ann Rheum Dis. 2011 Dec;70(12):2063-70
references: 22039166
references: N Engl J Med. 2011 Dec 8;365(23):2205-19
references: 22150039
references: Expert Rev Clin Immunol. 2012 May;8(4):319-31
references: 22607178
references: Bull NYU Hosp Jt Dis. 2011;69(3):233-7
references: 22035435
references: Immunity. 2012 Apr 20;36(4):542-50
references: 22520847
references: Arthritis Rheum. 2008 Jan;58(1):15-25
references: 18163481
references: Arthritis Rheum. 2013 Mar;65(3):559-70
references: 23348607