Department of Rheumatology and Immunology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, Fujian, China.
Department of Rheumatology and Immunology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Clin Rheumatol. 2024 Oct;43(10):3139-3145. doi: 10.1007/s10067-024-07103-2. Epub 2024 Aug 13.
To estimate the effectiveness and safety of tofacitinib in treating systemic lupus erythematosus (SLE) patients with arthritis.
This research was a retrospective cohort study that focused on SLE patients who had arthritis and were treated with tofacitinib at the Department of Rheumatology and Immunology from January 2020 to January 2022. Clinical outcomes, disease activity, immunological parameters, and adverse events were systematically evaluated pre- and post-treatment at 4, 12, and 24 weeks.
Twenty-two patients were analyzed. At the 4-week mark, 5 (22.7%) patients were partially relieved, and 17 (77.3%) unalleviated. By the 12-week assessment, CR off corticosteroids was observed in four patients (18.2%), and CR on corticosteroids was seen in six patients (27.3%), with an additional six (27.3%) maintaining partial remission. At 24 weeks after treatment, three patients (13.6%) achieved CR off corticosteroids, ten patients (45.5%) achieved CR on corticosteroids, and all patients received remission. Compared to before treatment, The SLEDAI and PGA scores significantly improved. The level of C3 was increased significantly, and the absolute CD3 T cell count, the 28-tender and the 28-swollen joint count, and the levels of serum IL-6 were significantly decreased at 24 weeks after treatment.
Tofacitinib demonstrates significant therapeutic potential in SLE patients with arthritis, with a safety profile, and the therapeutic mechanism of tofacitinib may be related to reducing IL-6 expression and inhibiting T cell activation. Key Points • Tofacitinib demonstrates significant therapeutic potential in SLE patients with arthritis • The therapeutic mechanism of tofacitinib may be related to reducing IL-6 expression and inhibiting T cell activation.
评估托法替尼治疗关节炎系统性红斑狼疮（SLE）患者的有效性和安全性。
本研究为回顾性队列研究，纳入 2020 年 1 月至 2022 年 1 月在风湿免疫科接受托法替尼治疗的关节炎 SLE 患者，于治疗前及治疗后 4、12、24 周时系统评估临床结局、疾病活动度、免疫参数及不良反应。
共纳入 22 例患者。治疗 4 周时，5 例（22.7%）患者部分缓解，17 例（77.3%）未缓解；治疗 12 周时，4 例（18.2%）患者实现无激素缓解，6 例（27.3%）患者实现激素缓解，另外 6 例（27.3%）患者维持部分缓解；治疗 24 周时，3 例（13.6%）患者实现无激素缓解，10 例（45.5%）患者实现激素缓解，所有患者均达到缓解。与治疗前相比，SLEDAI 评分和 PGA 评分均显著改善，C3 水平显著升高，CD3+T 细胞绝对计数、28 个压痛关节数、28 个肿胀关节数及血清 IL-6 水平均显著降低。
托法替尼治疗关节炎 SLE 患者具有显著疗效，安全性良好，其治疗机制可能与降低 IL-6 表达、抑制 T 细胞激活有关。
• 托法替尼治疗关节炎 SLE 患者具有显著疗效
• 托法替尼的治疗机制可能与降低 IL-6 表达、抑制 T 细胞激活有关
