{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:04:02Z","timestamp":1779775442324,"version":"3.53.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Tofacitinib, the first approved oral small\u2010molecule Janus kinase inhibitor (JAKi), is widely used for treating rheumatoid arthritis (RA). This study aims to compare the drug retention rates of tofacitinib between elderly (\u2265\u200965\u2009years) and nonelderly (&lt;\u200965\u2009years) RA patients in a real\u2010world clinical setting in Taiwan and to identify clinical factors associated with treatment discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of RA patients receiving tofacitinib between 2015 and 2020, with follow\u2010up until December 31, 2021. Patients were categorized into an elderly group (\u2265\u200965\u2009years,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200982) and a nonelderly group (&lt;\u200965\u2009years,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009224). Drug discontinuation was defined as the cessation of tofacitinib during follow\u2010up. Primary outcomes included retention rates, reasons for discontinuation, and the incidence of adverse events. Kaplan\u2013Meier analysis and multivariate Cox proportional hazards models were used to identify independent factors for discontinuation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 306 RA patients were included (mean age: 56.97\u2009\u00b1\u200912.44\u2009years). The elderly group had a significantly higher prevalence of comorbidities, including hypertension, diabetes, hyperlipidemia, and osteoporosis. There was no significant difference in mean treatment duration (2.70\u2009\u00b1\u20091.73 vs. 2.61\u2009\u00b1\u20091.69\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7049). Kaplan\u2013Meier analysis showed no statistically significant difference in retention rates (Log\u2010rank test,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.425). Multivariate analysis revealed that age was not an independent risk factor for discontinuation (adjusted HR\u2009=\u20091.086, 95% CI: 0.729\u20131.618,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.685). Among 40 patients who discontinued due to adverse events, serious infection was the leading cause (35.0%), comprising 10 non\u2010fatal serious infection events and 4 infection\u2010related deaths. Major adverse cardiovascular events (MACE) occurred only in the elderly group (15.8%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In real\u2010world practice, the drug retention of tofacitinib in elderly RA patients is comparable to that in nonelderly patients. Despite a higher comorbidity burden, age itself is not an independent risk factor for treatment discontinuation. However, the risk of MACE is higher in elderly patients, necessitating careful cardiovascular assessment and monitoring before tofacitinib treatment. These findings suggest that tofacitinib is a viable option for elderly RA patients, provided individualized risk assessment is performed. Notably, discontinuation due to adverse events was substantially less frequent than discontinuation due to lack of efficacy, supporting the overall favorable tolerability of tofacitinib in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70683","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T08:45:52Z","timestamp":1779612352000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Safety and Retention of Tofacitinib in Elderly Versus Non\u2010elderly Patients With Rheumatoid Arthritis: A Retrospective Cohort Study in Taiwan"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0876-7877","authenticated-orcid":false,"given":"Li\u2010Huei","family":"Chiang","sequence":"first","affiliation":[{"name":"Department of Pharmacy Chang Gung Memorial Hospital, Linkou  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping\u2010Han","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine New Taipei Municipal TuCheng Hospital  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Fu","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine Chang Gung Memorial Hospital  Linkou Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Ling","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Chang Gung Memorial Hospital, Linkou  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu\u2010Cheng","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Chang Gung Memorial Hospital, Linkou  Taoyuan Taiwan"},{"name":"Department of Biomedical Sciences Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-1704","authenticated-orcid":false,"given":"Yao\u2010Fan","family":"Fang","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine Chang Gung Memorial Hospital  Linkou Taiwan"},{"name":"School of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(16)30173\u20108"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2669"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102013\u2010204223"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrd.2017.201"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1003668"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109071"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22688"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010017\u20100621\u20102"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13153"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109927"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756\u2010185x.14414"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102013\u2010204128"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756\u2010185x.70356"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14703"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102022\u2010223356"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(23)01525\u20108"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2174\/0115748871371535250728151758"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kel149"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0216624"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.051144"},{"issue":"2","key":"e_1_2_9_22_1","first-page":"234","article-title":"Safety and Efficacy of Etanercept Treatment in Elderly Subjects With Rheumatoid Arthritis","volume":"33","author":"Bathon J. 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