1. Evaluation of the effectiveness of Tofacitinib in rheumatoid arthritis in real clinical practice: The relationship between pain relief in the first 4 weeks and disease activity after 3–6 months
- Author
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A. E. Karateev, E. Yu. Pogozheva, V. N. Amirjanova, E. S. Filatova, A. M. Lila, V. I. Mazurov, R. R. Samigullina, A. M. Dadalova, A. Yu. Dyo, D. S. Chakieva, A. A. Baranov, N. A. Lapkina, E. N. Koltsova, N. A. Kiryukhina, I. N. Shchendrigin, T. G. Rasevich, A. F. Davydova, I. V. Semizarova, I. A. Shafieva, I. B. Bashkova, D. A. Bobrikova, D. A. Murtazalieva, I. N. Kushnir, E. V. Kalinina, T. S. Salnikova, I. M. Marusenko, O. V. Semagina, I. B. Vinogradova, D. G. Krechikova, M. Yu. Semchenkova, and E. L. Nasonov
- Subjects
rheumatoid arthritis ,medicine.medical_specialty ,Central sensitization ,Visual analogue scale ,Immunology ,Diseases of the musculoskeletal system ,Gastroenterology ,Rheumatology ,Internal medicine ,medicine ,Immunology and Allergy ,Rheumatoid factor ,pain ,Leflunomide ,Tofacitinib ,tofacitinib ,business.industry ,activity ,central sensitization ,Brief Pain Inventory Questionnaire ,medicine.disease ,RC925-935 ,Rheumatoid arthritis ,correlation ,Methotrexate ,business ,medicine.drug - Abstract
The JAK inhibitor tofacitinib (TOFA) blocks the intracellular signaling pathway that activates the synthesis of cytokines and mediators involved in the development of pain and central sensitization (CS), which determines the rapid analgesic effect. However, it is not clear how pain reduction is associated with achieving low activity in rheumatoid arthritis (RA).The aim of the studywas to assess the relationship between the early clinical response to tofacitinib and a decrease in rheumatoid arthritis activity after 3 and 6 months.Material and methods.The study group consisted of 88 RA patients (age – 53±11.5 years; 79.3% of women) who received basic anti-inflammatory drugs (59.5% – methotrexate, 19.8% – leflunomide) and who were prescribed TOFA in a dose 10 mg/day. Seropositivity for rheumatoid factor was 89.8%; the value of the DAS28 index is 5.2±1.2. The severity of pain was assessed using the Brief Pain Inventory questionnaire, the neuropathic component of pain (NCP) – using the PainDETECT questionnaire, signs of CS – using the Central Sensitization Inventory (CSI) questionnaire in the early stages after the administration of TOFA, RA activity – using the DAS28-CRP index after 3 and 6 months.Results.The mean severity of pain at baseline was 5.3±2.0 on the visual analogue scale (VAS); 51.1% of patients had signs of CS (CSI>40), 15.9% had NCP (PainDETECT>18). 7 days after the start of therapy, there was a significant decrease in pain – to 4.1±1.8 according to VAS (pConclusions.The use of the JAK inhibitor TOFA allows achieving a quick analgesic effect and reducing the signs of CS. An early clinical response to TOFA (pain relief) predicts a decrease in RA activity after 3 and 6 months of therapy.
- Published
- 2021