Abstract:

Objective To explore the clinical efficacy and safety of tofacitinib in the treatment of difficult⁃ to ⁃treat rheumatoid arthritis（D2T ⁃RA）. Methods Fifty ⁃one patients with D2T ⁃RA who had received therapies with tofacitinib for 24 weeks were included into this study. Disease activity indicators including disease activity score 28 joint count⁃C⁃reactive protein（DAS28CRP），disease activity score 28 joint count⁃erythrocyte sedimentation rate （DAS28ESR），erythrocyte sedimentation rate（ESR），C⁃reactive protein（CRP），swollen joints count，tender joints count，visual analogue score（VAS）and safety indicators were observed prior to treatment initiation and at weeks 4，12，and 24 after Tofacitinib treatment. Results As compared with the baselines，DAS28CRP，DAS28ESR，CRP， ESR，swollen joints count，tender joints count and VAS were all significantly decreased at weeks 4，12 and 24 after tofacitinib treatment（P < 0.05）. As compared with 4 weeks of treatment，DAS28CRP，DAS28ESR，swollen joints count，tender joints count and VAS were all significantly decreased at weeks 12 and 24（P < 0.05）. The patients with no previous therapies with biologic DMARDs were more likely to achieve the RDA of DAS28CRP than those with prior uses of DMARDs（82.35% vs. 76.47%）. No adverse events including thrombosis，severe infection，and ane⁃ mia occurred. Conclusions Tofacitinib can effectively improve symptoms，signs，and inflammatory indexes， and rapidly reduce the disease activity of D2T RA in the short term. It also has a better safety.

Key words:

difficult ?to ?treat rheumatoid arthritis, tofacitinib, clinical efficacy, disease activity, safety ,