Rheumatoid arthritis

Identification of two tofacitinib subpopulations with different relative risk versus TNF inhibitors: an analysis of the open label, randomised controlled study ORAL Surveillance

Ann Rheum DisPublished Secondary analysis of the ORAL Surveillance randomised trial

An erratum to this article was published (Ann Rheum Dis, 15 Feb 2024 ↗)

Primary result · Malignancies (excl. non-melanoma skin cancer), MACE, MI, VTE and all-cause death: 'high-risk' subpopulation (age ≥65 years or ever smoker)Result — go to the resultHazard ratio 1.41-5.19

Authors' conclusion

This posthoc analysis of ORAL Surveillance identified two tofacitinib subpopulations with different relative risk versus TNFi. High risk was confined to patients defined by distinct risk factors age ≥65 years or smoking, and these differentiating risk factors accounted for the excess risk observed with tofacitinib versus TNFi.

Study context

Population
Patients with RA aged ≥50 years with ≥1 additional cardiovascular risk factor
Comparison
Tofacitinib 5 or 10 mg twice daily (combined doses) vs TNFi, by age and smoking subpopulations
Methodological detailsopen label, post hoc, event-driven, subgroup analysis
  • Open label
  • Post hoc
  • Event-driven
  • Subgroup analysis

Primary result

As reported in the abstract

Malignancies (excl. non-melanoma skin cancer), MACE, MI, VTE and all-cause death: 'high-risk' subpopulation (age ≥65 years or ever smoker)

Hazard ratio

1.41-5.19

Original publication

Identification of two tofacitinib subpopulations with different relative risk versus TNF inhibitors: an analysis of the open label, randomised controlled study ORAL Surveillance. Ann Rheum Dis. Published 17 March 2023. doi:10.1136/ard-2022-223715

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