Li Zhanguo, An Yuan, Su Houheng, Li Xiangpei, Xu Jianhua, Zheng Yi, Li Guiye, Kwok Kenneth, Wang Lisy, Wu Qizhe
Peking University People's Hospital, Beijing, China.
Qingdao Municipal Hospital, Qingdao, China.
Int J Rheum Dis. 2018 Feb;21(2):402-414. doi: 10.1111/1756-185X.13244. Epub 2018 Jan 4.
Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assess the effect of tofacitinib + conventional synthetic disease-modifying anti rheumatic drugs (csDMARDs) on patient-reported outcomes in Chinese patients with RA and inadequate response to DMARDs.
This analysis of data from the Phase 3 study ORAL Sync included Chinese patients randomized 4 : 4 : 1 : 1 to receive tofacitinib 5 mg twice daily, tofacitinib 10 mg twice daily, placebo→tofacitinib 5 mg twice daily, or placebo→tofacitinib 10 mg twice daily, with csDMARDs. Placebo non-responders switched to tofacitinib at 3 months; the remaining placebo patients switched at 6 months. Least squares mean changes from baseline were reported for Health Assessment Questionnaire-Disability Index (HAQ-DI), patient assessment of arthritis pain (Pain), patient global assessment of disease activity (PtGA), physician global assessment of disease activity (PGA), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scores, Short Form 36 (SF-36), and Work Limitations Questionnaire (WLQ), using a mixed-effects model for repeated measures.
Overall, 216 patients were included (tofacitinib 5 mg twice daily, n = 86; tofacitinib 10 mg twice daily, n = 86; placebo→tofacitinib 5 mg twice daily, n = 22; placebo→tofacitinib 10 mg twice daily, n = 22). At month 3, tofacitinib elicited significant improvements in HAQ-DI, Pain, PtGA, PGA and SF-36 Physical Component Summary scores. Improvements were generally maintained through 12 months.
Tofacitinib 5 and 10 mg twice daily + csDMARDs resulted in improvements in health-related quality of life, physical function and Pain through 12 months in Chinese patients with RA.
托法替布是一种用于治疗类风湿关节炎(RA)的口服Janus激酶抑制剂。我们评估托法替布联合传统合成改善病情抗风湿药(csDMARDs)对中国RA患者且对DMARDs反应不足的患者报告结局的影响。
这项对3期研究ORAL Sync数据的分析纳入了中国患者,他们按4:4:1:1随机分组,分别接受每日两次5毫克托法替布、每日两次10毫克托法替布、安慰剂→每日两次5毫克托法替布或安慰剂→每日两次10毫克托法替布,并联合csDMARDs。安慰剂无反应者在3个月时换用托法替布;其余安慰剂患者在6个月时换用。使用重复测量的混合效应模型报告健康评估问卷残疾指数(HAQ-DI)、患者对关节炎疼痛的评估(疼痛)、患者对疾病活动的整体评估(PtGA)、医生对疾病活动的整体评估(PGA)、慢性病治疗功能评估-疲劳(FACIT-F)评分、简明健康状况调查量表(SF-36)和工作限制问卷(WLQ)相对于基线的最小二乘均值变化。
总体而言,共纳入216例患者(每日两次5毫克托法替布组,n = 86;每日两次10毫克托法替布组,n = 86;安慰剂→每日两次5毫克托法替布组,n = 22;安慰剂→每日两次10毫克托法替布组,n = 22)。在第3个月时,托法替布使HAQ-DI、疼痛、PtGA、PGA和SF-36身体成分总结评分有显著改善。这些改善通常维持到12个月。
每日两次5毫克和10毫克托法替布联合csDMARDs可使中国RA患者在12个月内健康相关生活质量、身体功能和疼痛得到改善。