Medicina (Aug 2023)

Long-Term Retention Rate of Tofacitinib in Rheumatoid Arthritis: An Italian Multicenter Retrospective Cohort Study

  • Marino Paroli,
  • Andrea Becciolini,
  • Elena Bravi,
  • Romina Andracco,
  • Valeria Nucera,
  • Simone Parisi,
  • Francesca Ometto,
  • Federica Lumetti,
  • Antonella Farina,
  • Patrizia Del Medico,
  • Matteo Colina,
  • Alberto Lo Gullo,
  • Viviana Ravagnani,
  • Palma Scolieri,
  • Maddalena Larosa,
  • Marta Priora,
  • Elisa Visalli,
  • Olga Addimanda,
  • Rosetta Vitetta,
  • Alessandro Volpe,
  • Alessandra Bezzi,
  • Francesco Girelli,
  • Aldo Biagio Molica Colella,
  • Rosalba Caccavale,
  • Eleonora Di Donato,
  • Giuditta Adorni,
  • Daniele Santilli,
  • Gianluca Lucchini,
  • Eugenio Arrigoni,
  • Ilaria Platè,
  • Natalia Mansueto,
  • Aurora Ianniello,
  • Enrico Fusaro,
  • Maria Chiara Ditto,
  • Vincenzo Bruzzese,
  • Dario Camellino,
  • Gerolamo Bianchi,
  • Francesca Serale,
  • Rosario Foti,
  • Giorgio Amato,
  • Francesco De Lucia,
  • Ylenia Dal Bosco,
  • Roberta Foti,
  • Massimo Reta,
  • Alessia Fiorenza,
  • Guido Rovera,
  • Antonio Marchetta,
  • Maria Cristina Focherini,
  • Fabio Mascella,
  • Simone Bernardi,
  • Gilda Sandri,
  • Dilia Giuggioli,
  • Carlo Salvarani,
  • Veronica Franchina,
  • Francesco Molica Colella,
  • Giulio Ferrero,
  • Alarico Ariani

DOI
https://doi.org/10.3390/medicina59081480
Journal volume & issue
Vol. 59, no. 8
p. 1480

Abstract

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Background: Tofacitinib (TOFA) was the first Janus kinase inhibitor (JAKi) to be approved for the treatment of rheumatoid arthritis (RA). However, data on the retention rate of TOFA therapy are still far from definitive. Objective: The goal of this study is to add new real-world data on the TOFA retention rate in a cohort of RA patients followed for a long period of time. Methods: A multicenter retrospective study of RA subjects treated with TOFA as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was conducted in 23 Italian tertiary rheumatology centers. The study considered a treatment period of up to 48 months for all included patients. The TOFA retention rate was assessed with the Kaplan–Meier method. Hazard ratios (HRs) for TOFA discontinuation were obtained using Cox regression analysis. Results: We enrolled a total of 213 patients. Data analysis revealed that the TOFA retention rate was 86.5% (95% CI: 81.8–91.5%) at month 12, 78.8% (95% CI: 78.8–85.2%) at month 24, 63.8% (95% CI: 55.1–73.8%) at month 36, and 59.9% (95% CI: 55.1–73.8%) at month 48 after starting treatment. None of the factors analyzed, including the number of previous treatments received, disease activity or duration, presence of rheumatoid factor and/or anti-citrullinated protein antibody, and presence of comorbidities, were predictive of the TOFA retention rate. Safety data were comparable to those reported in the registration studies. Conclusions: TOFA demonstrated a long retention rate in RA in a real-world setting. This result, together with the safety data obtained, underscores that TOFA is a viable alternative for patients who have failed treatment with csDMARD and/or biologic DMARDs (bDMARDs). Further large, long-term observational studies are urgently needed to confirm these results.

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