Keywords
Tofacitinib
Clinical Cases
How to Cite
Abstract
Tofacitinib is a synthetic targeted disease modifying antirheumatic drug (DMARD), which has demonstrated safety and efficacy in multiple randomized, double-blind, controlled clinical trials, in different settings, for the treatment of moderate to severe rheumatoid arthritis (RA). Is the first drug of this type to be approved for the treatment of RA and its mechanism of action is exerted through inhibition of the enzyme Janus kinases (JAK), which mediate signal transmission to the intracellular environment of multiple cytokine receptors involved in the immune and inflammatory response. Tofacitinib has been approved in Argentina in september 2013, providing already important experience in clinical aspects and pharmacovigilance in patients of real life in this country. The aim of this paper is to present 2 clinical cases of tofacitinib use in daily clinical practice, which may be representative of common clinical scenarios.References
(1) Fox D a. Kinase Inhibition. A New Approach to the Treatment of Rheumatoid Arthritis. N Engl J Med. 2012;367(6):565-567.
(2) Maeshima K, Yamaoka K, Kubo S, et al. The JAK inhibitor tofacitinib regulates synovitis through inhibition of interferon-γ and interleukin-17 production by human CD4+ T cells. Arthritis Rheum. 2012;64(6):1790-1798.
(3) Strand V Zerbini CAF, Connell CA, Gruben D, Riese R, Wallenstein G VDHD. Oral scan: Effects of the oral JAK inhibitor tofacitinib in combination with methotrexate on patient reported outcomes in a 24-month phase 3 trial of active rheumatoid arthritis. Arthritis Rheum. 2013;65:S996.
(4) Van Vollenhoven RF, Fleischmann R, Cohen S, et al. Tofacitinib or Adalimumab versus Placebo in Rheumatoid Arthritis. N Engl J Med. 2012;367(6):508-519.
(5) Fleischmann R, Kremer J, Cush J, et al. Placebo-Controlled Tri al of Tofacitinib Monotherapy in Rheumatoid Arthritis. N Engl J Med. 2012;367(6):495-507.
(6) Burmester GR, Blanco R, Charles-Schoeman C, et al. Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response totumour necrosis factor inhibitors: a randomised phase 3 trial. L ancet. 2013;381(9865):451-460.
(7) Kremer J, Li Z, Hall S, et al. Tofacitinib in combination with nonbiologic disease-modifying antirheumatic drugs in patients with active rheumatoid arthritis: a randomized trial. Ann Intern Med. 2013;159(4):253-261.
(8) L ee EB, Fleischmann R, Hall S, et al. Tofacitinib versus methotrexate in rheumatoid arthritis. N Engl J Med. 2014;370(25):2377-2386.