Yıl: 2020 Cilt: 73 Sayı: 1 Sayfa Aralığı: 20 - 25 Metin Dili: Türkçe DOI: 10.4274/atfm.galenos.2019.38358 İndeks Tarihi: 24-10-2020

Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib

Öz:
Amaç: Çalışmamızda romatoid artrit (RA) nedeni ile tofasitinib kullanan hastaların klinik, laboratuvar ve demografik özelliklerini belirlemek ve ilaçtakalım oranlarını saptamak amaçlanmıştır.Gereç ve Yöntem: Mayıs 2016-Temmuz 2019 tarihleri arasında tofasitinib reçete edilmiş 78 RA hastası retrospektif olarak incelenerek çalışmayadahil edildi. Hastaların klinik, laboratuvar ve demografik verileri kaydedildi. İlaçta kalım hızları Kaplan-Meier sağ kalım analizi kullanılarak incelendi.P<0,05 istatistiksel olarak anlamlı kabul edildi.Bulgular: Tüm hastaların 62’si (%79,4) kadın olup, ortalama yaşları 58,6±11,3 yıldı. Tofasitinib öncesi biyolojik konvansiyonel hastalık modifiye ediciilaç (kHMEİ) kullanımı olan hasta sayısı 36 (%46,1) idi. Yirmi sekiz (%35,9) hastanın takiplerinde tedavisi sonlandırılmıştı. Tofasitinib kullanımı devamedenler ile ilaç kullanımı sonlandırılmış olan hastaların özellikleri karşılaştırıldığında tofasitinib kesilen grupta başlangıç SDAI skorunun istatistikselolarak anlamlı yüksek olduğu görüldü (p=0,028). Diğer özellikler gruplar arasında benzerdi. Takiplerinde monoterapi olarak tofasitinib kullananhastalarda ilaçta kalımın anlamlı fazla olduğu saptandı (p=0,012).Sonuç: RA tedavisinde kHMEİ ile remisyona giremeyen hastalarda, tofasitinib etkili bir tedavi ajanı olarak düşünülebilir.
Anahtar Kelime:

Tofacitinib in Patients with Rheumatoid Arthritis: Single-center Experience Rheumatoid Arthritis and Tofacitinib

Öz:
Objectives: In this study, we aimed to determine the clinical, laboratory and demographic characteristics of patients with rheumatoid arthritis (RA) using tofacitinib, and the drug survival rates. Materials and Methods: A total of 78 RA patients who were prescribed tofacitinib between May 2016 and July 2019 were retrospectively evaluated and included in the study. The clinical, laboratory and demographic features of the patients were recorded. Drug survival rates were analyzed using Kaplan-Meier survival analysis. P<0.05 was considered statistically significant. Results: The mean age of all patients was 58.6±11.3 years and 62 (79.4%) were female. Thirty-six (46.1%) of the patients had used biological disease modifying drug (DMARD) prior to the use of tofacitinib. In 28 (35.9%) patients, tofacitinib treatment was discontinued. When the characteristics of the patients were compared according to the continuation of tofasitinib, the initial SDAI score was significantly higher in the group in which tofacitinib was discontinued (p=0.028). Other features were similar between the groups. Drug survival was significantly higher in patients who underwent tofacitinib monotherapy at follow-up (p=0.012). Conclusion: Tofacitinib may be considered as an effective treatment agent in patients who cannot undergo remission with conventional DMARDs in the treatment of RA.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Strand V, Khanna D. The impact of rheumatoid arthritis and treatment on patients’ lives. Clin Exp Rheumatol. 2010;28(3 Suppl 59):S32-40.
  • 2. Smolen JS, Landewé R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological diseasemodifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017;76:960- 977.
  • 3. Fleischmann R, Mysler E, Hall S, et al. Efficacy and safety of tofacitinib monotherapy, tofacitinib with methotrexate, and adalimumab with methotrexate in patients with rheumatoid arthritis (ORAL Strategy): a phase 3b/4, double-blind, head-to-head, randomised controlled trial. Lancet. 2017;390:457-468.
  • 4. Van Vollenhoven RF, Fleischmann R, Cohen S, et al. Tofacitinib or adalimumab versus placebo in rheumatoid arthritis. Rheumatology (Oxford). 2016;55:1031-1041.
  • 5. Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62:2569-2581.
  • 6. van Gestel AM, Haagsma CJ, van Riel PL. Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum. 1998;41:1845-1850.
  • 7. Smolen JS, Breedveld FC, Schiff MH, et al. A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology. 2003;42:244-257.
  • 8. Nurmohamed MT, Dijkmans BA. Are biologics more effective than classical disease-modifying antirheumatic drugs? Arthritis Res Ther. 2008;10:118.
  • 9. Burmester GR, Blanco R, Charles-Schoeman C, et al. Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: a randomised phase 3 trial. Lancet. 2013;381:451-460.
  • 10. Kremer J, Li Z-G, Hall S, et al. Tofacitinib in Combination With Nonbiologic Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis: A Randomized Trial. Ann Intern Med. 2013;159:253-261.
  • 11. Fleischmann R, Kremer J, Cush J, et al. Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis. N Engl J Med. 2012;367:495-507.
  • 12. Wollenhaupt J, Silverfield J, Lee EB, et al. Safety and efficacy of tofacitinib, an oral janus kinase inhibitor, for the treatment of rheumatoid arthritis in open-label, longterm extension studies. J Rheumatol. 2014;41:837-852.
  • 13. Cohen SB, Tanaka Y, Mariette X, et al. Long-term safety of tofacitinib for the treatment of rheumatoid arthritis up to 8.5 years: integrated analysis of data from the global clinical trials. Ann Rheum Dis. 2017;76:1253-1262.
  • 14. European Medicines Agency. Xeljanz (tofacitinib): assessment report. 2017. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Public_ assessment_report/human/004214/WC500224913.pdf. Accessed 31 Oct 2017.
  • 15. Pope JE, Keystone E, Jamal S, et al. Persistence of Tofacitinib in the Treatment of Rheumatoid Arthritis in Open‐Label, Long‐Term Extension Studies up to 9.5 Years. ACR Open Rheumatol. 2019;1:73-82.
  • 16. Smolen JS, Kay J, Doyle MK, et al. Golimumab in patients with active rheumatoid arthritis after treatment with tumour necrosis factor α inhibitors (GO-AFTER study): a multicentre, randomised, double-blind, placebo-controlled, phase III trial. Lancet. 2009;374:210-221.
  • 17. Klareskog L, Gaubitz M, Rodriguez-Valverde V, et al ; Etanercept Study 301 Investigators. Assessment of long-term safety and efficacy of etanercept in a 5-year extension study in patients with rheumatoid arthritis. Clin Exp Rheumatol. 2011;29:238-247.
  • 18. Weinblatt ME, Keystone E, Furst DE, et al. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Ann Rheum Dis. 2006;65:753-759.
  • 19. Westhovens R, Kremer JM, Emery P, et al. Long-term safety and efficacy of abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: a 7-year extended study. Clin Exp Rheumatol. 2014;32:553-562.
  • 20. Souto A, Maneiro JR, Gomez-Reino JJ. Rate of discontinuation and drug survival of biologic therapies in rheumatoid arthritis: a systematic review and meta-analysis of drug registries and health care databases. Rheumatology. 2015;55:523-534.
APA YAYLA M, Sahin Eroglu D, TORGUTALP M, Sezer S, keleşoğlu dinçer a, Aydemir Guloksuz E, Yüksel M, Ates A, TURGAY T, kınıklı G (2020). Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. , 20 - 25. 10.4274/atfm.galenos.2019.38358
Chicago YAYLA Müçteba Enes,Sahin Eroglu Didem,TORGUTALP MURAT,Sezer Serdar,keleşoğlu dinçer ayşe bahar,Aydemir Guloksuz Emine Gozde,Yüksel Mehmet Levent,Ates Askin,TURGAY TAHSİN MURAT,kınıklı Gülay Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. (2020): 20 - 25. 10.4274/atfm.galenos.2019.38358
MLA YAYLA Müçteba Enes,Sahin Eroglu Didem,TORGUTALP MURAT,Sezer Serdar,keleşoğlu dinçer ayşe bahar,Aydemir Guloksuz Emine Gozde,Yüksel Mehmet Levent,Ates Askin,TURGAY TAHSİN MURAT,kınıklı Gülay Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. , 2020, ss.20 - 25. 10.4274/atfm.galenos.2019.38358
AMA YAYLA M,Sahin Eroglu D,TORGUTALP M,Sezer S,keleşoğlu dinçer a,Aydemir Guloksuz E,Yüksel M,Ates A,TURGAY T,kınıklı G Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. . 2020; 20 - 25. 10.4274/atfm.galenos.2019.38358
Vancouver YAYLA M,Sahin Eroglu D,TORGUTALP M,Sezer S,keleşoğlu dinçer a,Aydemir Guloksuz E,Yüksel M,Ates A,TURGAY T,kınıklı G Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. . 2020; 20 - 25. 10.4274/atfm.galenos.2019.38358
IEEE YAYLA M,Sahin Eroglu D,TORGUTALP M,Sezer S,keleşoğlu dinçer a,Aydemir Guloksuz E,Yüksel M,Ates A,TURGAY T,kınıklı G "Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib." , ss.20 - 25, 2020. 10.4274/atfm.galenos.2019.38358
ISNAD YAYLA, Müçteba Enes vd. "Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib". (2020), 20-25. https://doi.org/10.4274/atfm.galenos.2019.38358
APA YAYLA M, Sahin Eroglu D, TORGUTALP M, Sezer S, keleşoğlu dinçer a, Aydemir Guloksuz E, Yüksel M, Ates A, TURGAY T, kınıklı G (2020). Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 73(1), 20 - 25. 10.4274/atfm.galenos.2019.38358
Chicago YAYLA Müçteba Enes,Sahin Eroglu Didem,TORGUTALP MURAT,Sezer Serdar,keleşoğlu dinçer ayşe bahar,Aydemir Guloksuz Emine Gozde,Yüksel Mehmet Levent,Ates Askin,TURGAY TAHSİN MURAT,kınıklı Gülay Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73, no.1 (2020): 20 - 25. 10.4274/atfm.galenos.2019.38358
MLA YAYLA Müçteba Enes,Sahin Eroglu Didem,TORGUTALP MURAT,Sezer Serdar,keleşoğlu dinçer ayşe bahar,Aydemir Guloksuz Emine Gozde,Yüksel Mehmet Levent,Ates Askin,TURGAY TAHSİN MURAT,kınıklı Gülay Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol.73, no.1, 2020, ss.20 - 25. 10.4274/atfm.galenos.2019.38358
AMA YAYLA M,Sahin Eroglu D,TORGUTALP M,Sezer S,keleşoğlu dinçer a,Aydemir Guloksuz E,Yüksel M,Ates A,TURGAY T,kınıklı G Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020; 73(1): 20 - 25. 10.4274/atfm.galenos.2019.38358
Vancouver YAYLA M,Sahin Eroglu D,TORGUTALP M,Sezer S,keleşoğlu dinçer a,Aydemir Guloksuz E,Yüksel M,Ates A,TURGAY T,kınıklı G Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020; 73(1): 20 - 25. 10.4274/atfm.galenos.2019.38358
IEEE YAYLA M,Sahin Eroglu D,TORGUTALP M,Sezer S,keleşoğlu dinçer a,Aydemir Guloksuz E,Yüksel M,Ates A,TURGAY T,kınıklı G "Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib." Ankara Üniversitesi Tıp Fakültesi Mecmuası, 73, ss.20 - 25, 2020. 10.4274/atfm.galenos.2019.38358
ISNAD YAYLA, Müçteba Enes vd. "Romatoid Artritli Hastalarda Tofasitinib: Tek Merkez Deneyimi Romatoid Artirit ve Tofasitinib". Ankara Üniversitesi Tıp Fakültesi Mecmuası 73/1 (2020), 20-25. https://doi.org/10.4274/atfm.galenos.2019.38358