PMID- 29139090
OWN - NLM
STAT- MEDLINE
DCOM- 20180726
LR  - 20220317
IS  - 1179-1950 (Electronic)
IS  - 0012-6667 (Linking)
VI  - 77
IP  - 18
DP  - 2017 Dec
TI  - Tofacitinib: A Review in Rheumatoid Arthritis.
PG  - 1987-2001
LID - 10.1007/s40265-017-0835-9 [doi]
AB  - Tofacitinib (Xeljanz((R))) is a potent, selective JAK inhibitor that preferentially 
      inhibits Janus kinase (JAK) 1 and JAK3. In the EU, oral tofacitinib 5 mg twice 
      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. Several clinical studies of </= 24 months' 
      duration showed that tofacitinib monotherapy (as first- or second-line treatment) 
      and combination therapy with a conventional synthetic DMARD (csDMARD; as second- 
      or third-line treatment) was effective in reducing signs and symptoms of disease 
      and improving health-related quality of life (HR-QOL), with benefits sustained 
      during long-term therapy (</= 96 months). Tofacitinib monotherapy inhibited 
      progression of structural damage in methotrexate-naive patients during 
      </= 24 months' treatment, with beneficial effects also seen in patients receiving 
      tofacitinib plus methotrexate as second-line therapy for 12 months. Tofacitinib 
      was generally well tolerated during </= 114 months' treatment, with most adverse 
      events of mild or moderate severity. The tolerability profile of tofacitinib was 
      generally similar to that of biological DMARDs (bDMARDs), with infections and 
      infestations the most common adverse events (AEs) in tofacitinib recipients. 
      However, the incidence of herpes zoster (HZ) was higher with tofacitinib than in 
      the general RA population, although infections were clinically manageable. When 
      added to background methotrexate, tofacitinib was noninferior to adalimumab in 
      terms of efficacy, and both combination therapies had generally similar 
      tolerability profiles. Although additional comparative studies are needed to more 
      definitively position tofacitinib relative to bDMARDs and other targeted 
      synthetic DMARDs, current evidence indicates that oral tofacitinib is a useful 
      option for the treatment of patients with RA.
FAU - Dhillon, Sohita
AU  - Dhillon S
AD  - Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. 
      demail@springer.com.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Piperidines)
RN  - 0 (Pyrimidines)
RN  - 0 (Pyrroles)
RN  - 87LA6FU830 (tofacitinib)
RN  - EC 2.7.10.2 (Janus Kinases)
RN  - FYS6T7F842 (Adalimumab)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adalimumab/therapeutic use
MH  - Antirheumatic Agents/adverse effects/chemistry/pharmacology/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Janus Kinases/*antagonists & inhibitors
MH  - Methotrexate/therapeutic use
MH  - Piperidines/adverse effects/chemistry/pharmacology/*therapeutic use
MH  - Pyrimidines/adverse effects/chemistry/pharmacology/*therapeutic use
MH  - Pyrroles/adverse effects/chemistry/pharmacology/*therapeutic use
EDAT- 2017/11/16 06:00
MHDA- 2018/07/27 06:00
CRDT- 2017/11/16 06:00
PHST- 2017/11/16 06:00 [pubmed]
PHST- 2018/07/27 06:00 [medline]
PHST- 2017/11/16 06:00 [entrez]
AID - 10.1007/s40265-017-0835-9 [pii]
AID - 10.1007/s40265-017-0835-9 [doi]
PST - ppublish
SO  - Drugs. 2017 Dec;77(18):1987-2001. doi: 10.1007/s40265-017-0835-9.