Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2013 Aug;28(8):1134-8. doi: 10.3346/jkms.2013.28.8.1134. Epub 2013 Jul 31.
Tofacitinib, a novel Janus kinase inhibitor, may prevent structural damage in rheumatoid arthritis (RA). In this cohort study, we compared radiographic progression of hand joints between 21 RA patients who took tofacitinb for 18 months in a phase IIb and its extension study and 42 patients who took conventional disease modifying antirheumatic drugs (DMARDs), using simple erosion narrowing score. For tofacitinib group, changes before and after the treatment were also compared. The changes of erosion and sum scores were significantly less in tofacitinib than DMARDs group (for erosion, -0.60 ± 1.83 vs 0.51 ± 1.77, P = 0.038; for sum, -0.50 ± 1.72 vs 1.57 ± 4.13, P = 0.012). Joint space narrowing score (JSN) was also less in tofacitinib group (0.095 ± 0.58 vs 1.06 ± 2.60, P = 0.055). In tofacitinib group, yearly rates of both erosion and JSN were significantly decreased after administration of tofacitinib (For erosion, 0.62 ± 0.93 to -0.14 ± 0.48, P = 0.009; for JSN, 0.47 ± 0.64 to 0.03 ± 0.40, P = 0.032), as was change of sum score (1.09 ± 1.27 to -0.10 ± 0.63, P < 0.001). In conclusion, tofacitinib may prevent structural damage caused by RA.
托法替尼是一种新型的 Janus 激酶抑制剂，可能预防类风湿关节炎（RA）的结构损伤。在这项 IIb 期和扩展研究的队列研究中，我们比较了 21 例接受托法替尼治疗 18 个月的 RA 患者和 42 例接受传统疾病修饰抗风湿药物（DMARDs）治疗的患者的手部关节放射学进展，使用简单侵蚀狭窄评分。对于托法替尼组，还比较了治疗前后的变化。与 DMARDs 组相比，托法替尼组的侵蚀和总分变化明显较小（侵蚀，-0.60 ± 1.83 与 0.51 ± 1.77，P = 0.038；总分，-0.50 ± 1.72 与 1.57 ± 4.13，P = 0.012）。托法替尼组的关节间隙狭窄评分（JSN）也较小（0.095 ± 0.58 与 1.06 ± 2.60，P = 0.055）。在托法替尼组中，托法替尼给药后侵蚀和 JSN 的年发生率均显著降低（侵蚀，0.62 ± 0.93 至-0.14 ± 0.48，P = 0.009；JSN，0.47 ± 0.64 至 0.03 ± 0.40，P = 0.032），总分的变化也如此（1.09 ± 1.27 至-0.10 ± 0.63，P < 0.001）。总之，托法替尼可能预防 RA 引起的结构损伤。
