Joint-level responses to tofacitinib and methotrexate: a post hoc analysis of data from ORAL Start
Authors' conclusion
We observed variation in joint-specific responses with tofacitinib and methotrexate monotherapy. Despite a proximal-distal efficacy gradient, with better clinical responses in the feet, patients receiving methotrexate monotherapy demonstrated more radiographic progression in the foot joints compared with those receiving tofacitinib.
Study context
- Population
- MTX-naïve patients with rheumatoid arthritis (RA)
- Comparison
- Tofacitinib 5 and 10 mg BID vs MTX monotherapy; tofacitinib 5 vs 10 mg BID
- Primary endpoint
- Percentage change from baseline in paired joint pathology score (%∆paired joint pathology score (PJPS), from bilateral tender/swollen joint counts) for each joint pair
- Follow-up
- Month 3, month 6 and month 12
Methodological detailspost hoc analysis, phase III
- Post hoc analysis
- Phase III
Primary result
As reported in the abstract
%∆PJPS by joint location
- Greater responses with tofacitinib vs MTX in most joint locations
- Lesser responses with tofacitinib vs MTX in most joints of the feet, particularly at month 12
- Post hoc analysis
Further findings
Radiographic progression (mTSS) · month 12
- Significantly worse in the foot (and metacarpophalangeal) joints with MTX vs tofacitinib
Original publication
Joint-level responses to tofacitinib and methotrexate: a post hoc analysis of data from ORAL Start. Arthritis Res Ther. Published 29 September 2023. doi:10.
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