AB1381-HPR ADAPTABILITY, EFFECTIVENESS AND SAFETY OF TOFACITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Fernando Rodriguez, Anggie Aza, Michael Cabrera, Pedro Santos-Moreno, Diana Buitrago-Garcia
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Tofacitinib is a, selective JAK inhibitor that preferentially inhibits Janus kinase (JAK) 1 and JAK3. Oral tofacitinib 5 mg twice daily or 11 mg once daily is indicated for the treatment of moderate to severe active rheumatoid arthritis (RA) in adult patients who have responded inadequately to, or who are intolerant of, one or more DMARDs. Mainly, one of the strengths of Tofacitinib, is that it is a very suitable medicine for those patients who are afraid of applying a parenteral biological medicine, or who are of advanced age or are at high risk of adverse events, therefore It's easy to discontinue it. <h3>Objectives</h3> We aim to describe the tolerance and adaptability of patients to Tofacitinib, as well as the effectiveness and safety in patients with RA in a real-life setting in Bogotá, Colombia. <h3>Methods</h3> During 2017 and 2018 we followed-up patients from a RA specialized center in Colombia receiving Tofacitinib. Patients were treated with therapeutic goals type T2T and a multidisciplinary approach. Clinical follow-up was designed by the authors according to DAS28 as follows: every 3-5 weeks (DAS28 &gt; 5.1), every 7-9 weeks (DAS28 ≥ 3.1 and ≤ 5.1), and every 11-13 weeks (DAS28 &lt; 3.1). Tender joint count (TJC), swollen joint count (SJC) and DAS28 were measured on each visit. Therapy had to be adjusted with DAS28 &gt; 3.2; We divided patients in four groups: remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA) patients and one aim of the study was to look at what percentage of patients who were in moderate or severe disease activity reached a low disease activity or remission. On the other hand, we evaluated the tolerance and adaptability of patients to Tofacitinib. Adverse events were classified according the Common Terminology Criteria for Adverse Events (CTCAE) of the World Health Organization. Descriptive epidemiology for continuous variables, measure of central tendency and dispersion for qualitative and categorical variables through percentages and averages were calculated. <h3>Results</h3> We included 59 patients receiving tofacitinib, 92% were women and 8% men during last two years. Mean age was 60 11. From total, 70% of patients received anti-TNF drugs before tofacitinib and the other 30%. In reference to the adaptability, most of the patients up to 95% expressed to be happy with the oral intake and the suitable dosage of the medication. Regarding effectiveness, mean DAS28 at beginning was 4.6 0.83 and at the end 2.6 0.63; At the beginning of follow-up 57.6% of patients were in moderate disease activity according to DAS28 and 33.9% in severe disease activity, while at the end of follow up 64% of patients achieved remission and 16.9% low disease activity during the 12 months of follow-up. See table 1. Regarding safety 2 patients presented a dermatological adverse event (herpes zoster) with adverse event rate of 3.3%. <h3>Conclusion</h3> Tofacitinib is a very suitable medicine in patients with RA and improved disease activity in impressive way; also proved to be very safe, except the occurrences of herpes zoster, which is an aspect to take into account in its prescription, but none of patients presented another serious adverse events. <h3>Disclosure of Interests</h3> Fernando Rodriguez: None declared, Anggie Aza: None declared, Michael Cabrera: None declared, Pedro Santos-Moreno Grant/research support from: Dr Santos has received research grants from Janssen, Abbvie and UCB, Speakers bureau: Dr Santos has received speaker fees from Sanofi, Lilly, Bristol, Pfizer, Abbvie, Janssen and UCB, Diana Buitrago-Garcia: None declared