{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:34:33Z","timestamp":1774438473336,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Biological disease\u2010modifying antirheumatic drugs (bDMARDs) are treatment options for refractory juvenile idiopathic arthritis (JIA) cases which cannot be afforded by the majority. Tofacitinib is a novel Janus kinase inhibitor, which is reported to be a cost\u2010effective oral alternative to biologics. This prospective observational study was carried out to observe the efficacy and safety of tofacitinib in refractory polyarticular course JIA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>The study was conducted in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Twenty\u2010seven refractory polyarticular course JIA patients were included in this study. Patients received tofacitinib at recommended doses. Disease activity level was assessed by Juvenile Arthritis Disease Activity Score (JADAS) 27. Cases were evaluated at baseline and at the 6th, 12th and 24th weeks. Safety was monitored from history, examination findings and laboratory reports. Data were analyzed using appropriate statistical tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Enthesitis\u2010related arthritis was the commonest type (37%) followed by polyarticular (rheumatoid factor+) and systemic JIA. There was significant improvement in JADAS 27 in all the subtypes of JIA except oligoarticular extended type. Among 100% high disease activity state cases at baseline, 70.4% were inactive at 24\u00a0weeks. It was also possible to significantly reduce the dose of steroid. Few side effects like headache and vomiting, elevation of alanine aminotransferase and anemia were observed at 6\u00a0weeks. These side effects subsequently improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Significant reduction of disease activity score was observed from baseline to follow up in this study. Tofacitinib was well tolerated with minimum side effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.14324","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T09:09:21Z","timestamp":1650272961000},"page":"678-684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Efficacy and safety of tofacitinib in the treatment of refractory cases of polyarticular course juvenile idiopathic arthritis: A\u00a0study from Bangladesh"],"prefix":"10.1111","volume":"25","author":[{"given":"Mohammad Masudur","family":"Rahman","sequence":"first","affiliation":[{"name":"Department of Paediatrics Bangabandhu Sheikh Mujib Medical University  Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamrul","family":"Laila","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Bangabandhu Sheikh Mujib Medical University  Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6494-9827","authenticated-orcid":false,"given":"Shahana Akhter","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Bangabandhu Sheikh Mujib Medical University  Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60363-8"},{"key":"e_1_2_10_3_1","first-page":"1258","volume-title":"Nelson Textbook of Pediatics","author":"Eveline YW","year":"2019"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1756-185X.2012.01703.x"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"1","article-title":"New advances in juvenile idiopathic arthritis","volume":"35","author":"Huang JL","year":"2012","journal-title":"Chang Gung Med J"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-6581-4.10013-5"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23870"},{"issue":"2","key":"e_1_2_10_8_1","first-page":"318","article-title":"The mechanism of action of tofacitinib\u2010an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis","volume":"34","author":"Hodge JA","year":"2016","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1003668"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34329"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.150284"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/0366\u20106999.245157"},{"key":"e_1_2_10_13_1","unstructured":"U.S. FDA Approves Pfizer\u2019s Xeljanz (Tofacitinib) for the Treatment of Active Polyarticular Course Juvenile Idiopathic Arthritis. News Release. Pfizer; September 28 2020.https:\/\/www.pfizer.com\/news\/press\u2010release\/press\u2010release\u2010detail\/us\u2010fda\u2010approves\u2010pfizers\u2010xeljanzr\u2010tofacitinib\u2010treatment. 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