Differences and Similarities in clinical and functional resp
This post hoc analysis assessed clinical and functional responses to tofacitinib monotherapy, tofacitinib+methotrexate (MTX), and adalimumab+MTX, in patients with rheumatoid arthritis enrolled in the ORAL Strategy study, including evaluation of patient-level data using cumulative probability plots.

In the 12-month, phase IIIb/IV ORAL Strategy study, patients with rheumatoid arthritis and an inadequate response to MTX were randomized to receive tofacitinib 5 mg twice daily (BID), tofacitinib 5 mg BID+MTX, or adalimumab 40 mg every other week+MTX. Median C-reactive protein (CRP) levels by time period were summarized by CDAI remission status at months 6 and 12.

Results:
--Data for 1146 patients were analyzed. At month 12, cumulative probability plots for AI and HAQ-DI were similar across treatments in patients with greater response.

--At lower levels of response, patients receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies.

--With tofacitinib+MTX, numerically higher baseline CRP levels and numerically larger post-baseline CRP reductions were seen in patients achieving CDAI remission at months 6 and 12 vs those who did not.

In conclusion, these findings imply that patients who had a higher reaction did better regardless of the treatment they got. Patients who had a lower response to tofacitinib monotherapy had better outcomes with combination treatments, implying that they benefited from MTX. Pre-treatment CRP levels that are high may be linked to a greater response to tofacitinib + MTX.

Source: https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-021-02591-y
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