Tofacitinib in combination with methotrexate in patients with rheumatoid arthritis: Patient-reported outcomes from the 24-month phase 3 ORAL scan study

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Strand, V
van der Heijde, D
Tanaka, Y
Keystone, E
Kremer, J
Zerbini, CAF
Cardiel, MH
Cohen, S
Nash, P
Song, YW
Tegzová, D
Gruben, D
Wallenstein, G
Connell, CA
Fleischmann, R
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2020
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Abstract

Objective Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Here we present data from the completed Phase 3 randomised controlled trial (RCT) ORAL Scan (NCT00847613), which evaluated the impact of tofacitinib on patient-reported outcomes (PROs) through 24 months in patients with active RA and inadequate responses to methotrexate (MTX-IR). Methods Patients were randomised 4:4:1:1 to receive tofacitinib 5 or 10 mg twice daily (BID), or placebo advanced to tofacitinib 5 or 10 mg, plus background MTX. Patients receiving placebo advanced to tofacitinib at month 3 (non-responders) or month 6 (remaining patients). Mean changes from baseline in PROs, assessed at months 1-24, included Health Assessment Questionnaire-Disability Index, Patient Global Assessment of disease activity (visual analogue scale [VAS]), Patient Assessment of Arthritis Pain (VAS), health-related quality of life (Short Form-36 version 2), Functional Assessment of Chronic Illness Therapy-Fatigue and Medical Outcomes Study-Sleep. Results Overall, 539/797 (67.6%) patients completed 24 months’treatment. At month 3, tofacitinib-treated patients reported significant (p<0.05) mean changes from baseline versus placebo across all PROs, and significantly more patients reported improvements ≥ minimum clinically important differences versus placebo. Improvements in PROs with tofacitinib were sustained to month 24. Following advancement to tofacitinib, placebo-treated patients generally reported changes of similar magnitude to tofacitinib-treated patients. Conclusion Patients with RA and MTX-IR receiving tofacitinib 5 or 10 mg BID plus MTX reported significant and clinically meaningful improvements in PROs versus placebo at month 3, which were sustained through 24 months.

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Clinical and Experimental Rheumatology

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38

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5

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Strand, V; van der Heijde, D; Tanaka, Y; Keystone, E; Kremer, J; Zerbini, CAF; Cardiel, MH; Cohen, S; Nash, P; Song, YW; Tegzová, D; Gruben, D; Wallenstein, G; Connell, CA; Fleischmann, R, Tofacitinib in combination with methotrexate in patients with rheumatoid arthritis: Patient-reported outcomes from the 24-month phase 3 ORAL scan study, Clinical and Experimental Rheumatology, 2020, 38 (5), pp. 848-857

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