Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): an open-label randomised study
Authors' conclusion
This study implies that a blanket cessation of tofacitinib may not be suitable for all patients, given that 58% of the participants experienced relapse. However, the withdrawal of tofacitinib is unlikely to result in the acquisition of treatment-resistance.
Study context
- Population
- Patients with RA with inadequate response to methotrexate (MTX) with or without bDMARDs48 in remission at week 52
- Participants
- 113 patients
- Comparison
- Tofacitinib discontinuation vs MTX discontinuation after CDAI remission at week 52 on tofacitinib plus MTX
- Tofacitinib discontinuationn = 24
- MTX discontinuationn = 20reference
- Primary endpoint
- Proportion of patients who sustained clinical remission
- Follow-up
- Week 104
Methodological detailsopen-label
- Open-label
Primary result
As reported in the abstract
Sustained remission
Further findings
- Remission on tofacitinib resumption after relapse · patients who relapsed after tofacitinib discontinuation — Tofacitinib discontinuation
- 71.4%
Bio-naïve patients · week 52 and week 104
- A greater proportion of bio-naïve patients achieved remission at week 52 and sustained low disease activity with tofacitinib discontinuation at week 104
Predictors of flare-free tofacitinib discontinuation · before discontinuation
- Lower RF in patients discontinuing tofacitinib without flares
- P = 0.04
- Lower anti-CCP antibody in patients discontinuing tofacitinib without flares
- P = 0.051
Safety
- No severe adverse events after discontinuation of tofacitinib or MTX
Original publication
Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): an open-label randomised study. RMD Open. Published 25 April 2023. doi:10.
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