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Research ArticleRheumatoid Arthritis

Physician- and Patient-reported Effectiveness Are Similar for Tofacitinib and TNFi in Rheumatoid Arthritis: Data From a Rheumatoid Arthritis Registry

Mohammad Movahedi, Angela Cesta, Xiyuing Li, Edward C. Keystone, Claire Bombardier and the OBRI Investigators
The Journal of Rheumatology May 2022, 49 (5) 447-453; DOI: https://doi.org/10.3899/jrheum.211066
Mohammad Movahedi
1M. Movahedi, MD, PhD, OBRI, Toronto General Research Institute, University Health Network, Toronto, and Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto;
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Angela Cesta
2A. Cesta, MSc, X. Li, MSc, OBRI, Toronto General Research Institute, University Health Network, Toronto;
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Xiyuing Li
2A. Cesta, MSc, X. Li, MSc, OBRI, Toronto General Research Institute, University Health Network, Toronto;
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Edward C. Keystone
3E.C. Keystone, MD, MaRS Center, Toronto;
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Claire Bombardier
4C. Bombardier, MD, OBRI, Toronto General Research Institute, University Health Network, Toronto, Division of Rheumatology, Department of Medicine, University of Toronto, and Department of Medicine and IHPME, University of Toronto, Toronto, Ontario, Canada.
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Abstract

Objective Tofacitinib (TOF) is an oral, small-molecule drug used for rheumatoid arthritis (RA) treatment and is one of several alternative treatments to tumor necrosis factor inhibitors (TNFi). We evaluated physician- and patient-reported effectiveness of TNFi compared to TOF, using real-world data from the Ontario Best Practices Research Initiative (OBRI).

Methods Patients enrolled in the OBRI initiating TOF or TNFi between 2014 and 2019 were included. Patients were required to have physician- and patient-reported effectiveness outcome data, including Clinical Disease Activity Index (CDAI) and RA Disease Activity Index (RADAI), available at treatment initiation and 6 (± 2) months later. To deal with confounding by indication, we estimated propensity scores (PS) for covariates.

Results Four hundred nineteen patients were included. Of those, 226 initiated a TNFi and 193 TOF, and had a mean (SD) disease duration of 8.0 (8.7) and 12.6 (9.6) years, respectively. In addition, the TNFi group was less likely to have prior biologic use (21.7%) compared to the TOF group (67.9%). The proportion of patients in CDAI low disease activity (LDA)/remission (REM) at 6 months was 36.7% and 33.2% in the TNFi and TOF groups, respectively. The generalized linear mixed models adjusting for PS quantile showed that there was no significant difference in CDAI LDA/REM (odds ratio [OR] 0.85, 95% CI 0.51–1.43) and RADAI coefficient (OR 0.48, 95% CI –0.18 to 1.14) between the 2 groups (ref: TOF).

Conclusion In patients with RA, physician- and patient-reported effectiveness are similar in the TNFi and TOF groups 6 months after treatment.

Key Indexing Terms:
  • disease activity
  • patient-reported outcomes
  • rheumatoid arthritis
  • TNFi
  • treatment
  • tofacitinib
  • Accepted for publication January 25, 2022.
  • Copyright © 2022 The Journal of Rheumatology
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The Journal of Rheumatology
Vol. 49, Issue 5
1 May 2022
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Physician- and Patient-reported Effectiveness Are Similar for Tofacitinib and TNFi in Rheumatoid Arthritis: Data From a Rheumatoid Arthritis Registry
Mohammad Movahedi, Angela Cesta, Xiyuing Li, Edward C. Keystone, Claire Bombardier, the OBRI Investigators
The Journal of Rheumatology May 2022, 49 (5) 447-453; DOI: 10.3899/jrheum.211066

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Physician- and Patient-reported Effectiveness Are Similar for Tofacitinib and TNFi in Rheumatoid Arthritis: Data From a Rheumatoid Arthritis Registry
Mohammad Movahedi, Angela Cesta, Xiyuing Li, Edward C. Keystone, Claire Bombardier, the OBRI Investigators
The Journal of Rheumatology May 2022, 49 (5) 447-453; DOI: 10.3899/jrheum.211066
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Keywords

DISEASE ACTIVITY
PATIENT-REPORTED OUTCOMES
RHEUMATOID ARTHRITIS
TNFi
TREATMENT
TOFACITINIB

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Keywords

  • disease activity
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  • rheumatoid arthritis
  • TNFi
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  • tofacitinib

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