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Tofacitinib in combination with methotrexate in patients with rheumatoid arthritis: patient-reported outcomes from the 24-month Phase 3 ORAL Scan study


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15

 

  1. Division of Immunology/Rheumatology, Stanford University, Palo Alto, CA, USA.
  2. Leiden University Medical Center, Leiden, the Netherlands.
  3. First Department of Internal Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan.
  4. Mount Sinai Hospital, University of Toronto, Toronto, Canada.
  5. Albany Medical College, Albany, NY, USA.
  6. Centro Paulista de Investigação Clinica, São Paulo, Brazil.
  7. Centro de Investigacion Clinica de Morelia, Mexico.
  8. Metroplex Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  9. University of Queensland, Australia.
  10. Department of Internal Medicine, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
  11. Institute of Rheumatology, Prague, Czech Republic.
  12. Pfizer Inc, Groton, CT, USA.
  13. Pfizer Inc, Groton, CT, USA. genewallenstein@yahoo.com
  14. Pfizer Inc, Groton, CT, USA.
  15. Metroplex Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.

for the ORAL Scan investigators

CER12492
2020 Vol.38, N°5
PI 0848, PF 0857
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PMID: 31858963 [PubMed]

Received: 10/06/2019
Accepted : 20/09/2019
In Press: 19/12/2019
Published: 02/10/2020

Abstract

OBJECTIVES:
Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Here we present data from the completed Phase 3 randomised controlled trial (RCT) ORAL Scan (NCT00847613), which evaluated the impact of tofacitinib on patient-reported outcomes (PROs) through 24 months in patients with active RA and inadequate responses to methotrexate (MTX-IR).
METHODS:
Patients were randomised 4:4:1:1 to receive tofacitinib 5 or 10 mg twice daily (BID), or placebo advanced to tofacitinib 5 or 10 mg, plus background MTX. Patients receiving placebo advanced to tofacitinib at month 3 (non-responders) or month 6 (remaining patients). Mean changes from baseline in PROs, assessed at months 1-24, included Health Assessment Questionnaire-Disability Index, Patient Global Assessment of disease activity (visual analogue scale [VAS]), Patient Assessment of Arthritis Pain (VAS), health-related quality of life (Short Form-36 version 2), Functional Assessment of Chronic Illness Therapy-Fatigue and Medical Outcomes Study-Sleep.
RESULTS:
Overall, 539/797 (67.6%) patients completed 24 months’ treatment. At month 3, tofacitinib-treated patients reported signi cant (p<0.05) mean changes from baseline versus placebo across all PROs, and significantly more patients reported improvements ≥ minimum clinically important differences versus placebo. Improvements in PROs with tofacitinib were sustained to month 24. Following advancement to tofacitinib, placebo-treated patients generally reported changes of similar magnitude to tofacitinib-treated patients.
CONCLUSIONS:
Patients with RA and MTX-IR receiving tofacitinib 5 or 10 mg BID plus MTX reported significant and clinically meaningful improvements in PROs versus placebo at month 3, which were sustained through 24 months.

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