{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T13:54:30Z","timestamp":1775224470924,"version":"3.50.1"},"reference-count":47,"publisher":"The Journal of Rheumatology","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Tofacitinib (TOF) is the first Janus kinase (JAK) inhibitor approved for psoriatic arthritis (PsA). It has shown efficacy in patients refractory to anti\u2013tumor necrosis factor-\u03b1 in randomized controlled trials (RCTs). Our aim was to assess efficacy and safety of TOF in clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>This was an observational, open-label multicenter study of PsA patients treated with TOF due to inefficacy or adverse events of previous therapies. Outcome variables were efficacy, corticosteroid dose-sparing effect, retention rate, and safety. A comparative study of clinical features between our cohort of patients and those from the OPAL Beyond trial was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>There were 87 patients (28 women\/59 men), with a mean age of 52.8 \u00b1 11.4 years. All patients were refractory to biologic disease-modifying antirheumatic drugs (DMARDs) and\/or to conventional synthetic DMARDs plus apremilast. TOF was started at 5 mg twice daily after a mean follow-up of 12.3 \u00b1 9.3 years from PsA diagnosis. At first month, Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) decreased from median 4.8 (IQR 4.1\u20135.4) to 3.7 (IQR 2.8\u20134.7,<jats:italic>P<\/jats:italic>&lt; 0.01), Disease Activity Index for Psoriatic Arthritis from median 28 (IQR 18.4\u201334.1) to 15.5 (IQR 10.1\u201325.7,<jats:italic>P<\/jats:italic>&lt; 0.01), and C-reactive protein from median 1.9 (IQR 0.3\u20135.0) to 0.5 (IQR 0.1\u20132.2) mg\/dL (<jats:italic>P<\/jats:italic>&lt; 0.01). Also, TOF led to a significant reduction in prednisone dose. Mild adverse effects were reported in 21 patients (24.13%), mainly gastrointestinal symptoms. TOF retention rate at Month 6 was 77% (95% CI 65.2\u201386.3). Patients in clinical practice were older with longer disease duration and received biologic agents more commonly than those in the OPAL Beyond trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Data from clinical practice confirm that TOF seems to be effective, rapid, and relatively safe in refractory PsA despite clinical differences with patients in RCTs.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.201204","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T12:22:30Z","timestamp":1617279750000},"page":"1552-1558","source":"Crossref","is-referenced-by-count":10,"title":["Treatment With Tofacitinib in Refractory Psoriatic Arthritis: A National Multicenter Study of the First 87 Patients in Clinical 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