Tofacitinib versus tocilizumab in the treatment of biological-naïve or previous biological-failure patients with methotrexate-refractory active rheumatoid arthritis

Findings from a multicentre cohort study in Japan provide important information that is expected to aid in determining the position of tofacitinib in the treatment algorithm for RA.Mori S, et al. compared therapeutic outcomes, from real-world registries, at 12 months between tofacitinib-treated and tocilizumab-treated patients to clarify whether tofacitinib should only be considered as an option for patients who have either failed to respond to at least one bDMARD or are MTX-resistant/-intolerant.The authors found that tofacitinib was more likely to induce and maintain clinical disease activity index (CDAI)-based improvements at 12 months, compared with tocilizumab, in bDMARD-naïve patients. However, these results were not replicated in previous bDMARD-failure patients.Overall, results from this study suggest that, in clinical practice, tofacitinib could be considered as another option for bDMARD-naïve patients with RA prior to the start of biological therapy.