Open AccessExperience with tofacitinib in Canada: patient characteristics and treatment patterns in rheumatoid arthritis over 3 years
Author(s) -
Janet Pope,
Louis Bessette,
Niall Jones,
Lara Fallon,
John Woolcott,
David Gruben,
Michael Crooks,
David Gold,
Boulos Haraoui
Publication year - 2019
Publication title -
rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.957
H-Index - 173
eISSN - 1462-0332
pISSN - 1462-0324
DOI - 10.1093/rheumatology/kez324
Subject(s) - tofacitinib , medicine , discontinuation , janus kinase inhibitor , rheumatoid arthritis , adverse effect , demographics , demography , sociology
Objectives To describe characteristics, treatment patterns and persistence in patients with RA treated with tofacitinib, an oral Janus kinase inhibitor, in Canadian clinical practice between 1 June 2014 and 31 May 2017. Methods Data were obtained from the tofacitinib eXel support programme. Baseline demographics and medication history were collected via patient report/special authorization forms; reasons for discontinuation were captured by patient report. Treatment persistence was estimated using Kaplan–Meier methods, with data censored at last follow-up. Cox regression was applied to analyse baseline characteristics associated with treatment discontinuation. Results The number of patients with RA enrolled from 2014 to 2017 was 4276; tofacitinib utilization increased during that period, as did the proportion of biologic (b) DMARD-naïve patients prescribed tofacitinib. Of patients who initiated tofacitinib, 1226/3678 (33.3%) discontinued, mostly from lack of efficacy (35.7%) and adverse events (26.9%). Persistence was 62.7% and 49.6% after 1 and 2 years of treatment, respectively. Prior bDMARD experience predicted increased tofacitinib discontinuation (vs bDMARD-naïve, P 65 years vs ⩽45 years; P 730, 613, 667 and 592 days, respectively. Conclusion Since 2014, tofacitinib use in Canadian patients with RA increased, especially among bDMARD-naïve/post-1 bDMARD patients. Median drug survival was ∼2 years. Likelihood of persistence increased for bDMARD-naïve (vs bDMARD-experienced) patients and those aged ⩾56 (vs ⩽45) years.