{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:04:42Z","timestamp":1776132282470,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The Canadian Tofacitinib for Rheumatoid Arthritis Observational (CANTORAL) is the first Canadian prospective, observational study assessing tofacitinib. The objective was to assess effectiveness and safety for moderate to severe rheumatoid arthritis (RA). Coprimary and secondary outcomes are reported from an interim analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients initiating tofacitinib from October 2017 to July\u20092020 were enrolled from 45\u2009Canadian sites. Coprimary outcomes (month 6) included the Clinical Disease Activity Index (CDAI)\u2013defined low disease activity (LDA) and remission. Secondary outcomes (to month 18) included the CDAI and the 4\u2010variable Disease Activity Score in 28\u2009joints (DAS28) using the erythrocyte sedimentation rate (ESR)\/C\u2010reactive protein (CRP) level to define LDA and remission; the proportions of patients achieving mild pain (visual analog scale &lt;20\u2009mm), and moderate (\u226530%) and substantial (\u226550%) pain improvements; and the proportions of patients achieving a Health Assessment Questionnaire disability index (HAQ DI) score\u2009greater or equal to \u2009normative values (\u22640.25) and a HAQ DI score\u2009greater or equal to minimum clinically important difference (MCID) (\u22650.22). Safety was assessed to month 36.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 504 patients initiating tofacitinib, 44.4% received concomitant methotrexate. At month 6, 52.9% and 15.4% of patients were in CDAI\u2010defined LDA and remission, respectively; a similar proportion of patients achieved outcomes by month 3 (first post\u2010baseline assessment). By month 3, 27.2% and 41.7% of patients, respectively, were in DAS28\u2010ESR\u2013defined LDA and DAS28\u2010CRP &lt;3.2; 14.7% and 25.8% achieved DAS28\u2010ESR remission and DAS28\u2010CRP &lt;2.6. By month 3, mild pain and moderate and substantial pain improvements occurred in 29.6%, 55.6%, and 42.9% of patients, respectively; 19.9% and 53.7% of patients achieved a HAQ DI score\u2009greater than or equal to\u2009normative values and a HAQ DI score\u2009greater than or equal to\u2009MCID, respectively. Outcomes were generally maintained to month 18. Incidence rates (events per 100 patient\u2010years) for treatment\u2010emergent adverse events (AEs), serious AEs, and discontinuations due to AEs were 126.8, 11.9, and 14.5, respectively, and AEs of special interest were infrequent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tofacitinib was associated with early and sustained improvement in RA signs and symptoms in real\u2010world patients. Effectiveness and safety were consistent with the established tofacitinib clinical profile.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24966","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T10:54:35Z","timestamp":1654772075000},"page":"240-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effectiveness and Safety of Tofacitinib in Canadian Patients With Rheumatoid Arthritis: Primary Results From a Prospective Observational Study"],"prefix":"10.1002","volume":"75","author":[{"given":"Boulos","family":"Haraoui","sequence":"first","affiliation":[{"name":"Institut de Rhumatologie de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majed","family":"Khraishi","sequence":"additional","affiliation":[{"name":"Memorial University of Newfoundland  St. John's Newfoundland Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Choquette","sequence":"additional","affiliation":[{"name":"Institut de Rhumatologie de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa","family":"Lisnevskaia","sequence":"additional","affiliation":[{"name":"Oshawa Clinic  Oshawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Teo","sequence":"additional","affiliation":[{"name":"University of British Columbia  Penticton British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassandra","family":"Kinch","sequence":"additional","affiliation":[{"name":"Pfizer Canada ULC  Kirkland Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corina","family":"Galos","sequence":"additional","affiliation":[{"name":"Pfizer Canada ULC  Kirkland Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrice","family":"Roy","sequence":"additional","affiliation":[{"name":"Pfizer Canada ULC  Kirkland Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gruben","sequence":"additional","affiliation":[{"name":"Pfizer Inc  Groton Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Woolcott","sequence":"additional","affiliation":[{"name":"Pfizer Inc  Collegeville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Vaillancourt","sequence":"additional","affiliation":[{"name":"JSS Medical Research  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Sampalis","sequence":"additional","affiliation":[{"name":"JSS Medical Research and University of McGill  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward C.","family":"Keystone","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Canadian Tofacitinib for Rheumatoid Arthritis Observational Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110207"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-216655"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41752"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60826-4"},{"key":"e_1_2_8_6_1","unstructured":"Pfizer Canada Inc.Xeljanz (product monograph).2019. 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