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Study to Evaluate Safety and Effects of Tofacitinib and Biologic Disease Modifying Antirheumatic Drugs in People Treated for Rheumatoid Arthritis

An Observational Study Within the CorEvitas Registry to Evaluate Safety and Effectiveness of Tofacitinib and Biologic Disease Modifying Antirheumatic Drugs (bDMARDs) in Japan Among Patients Treated for Moderately to Severely Active Rheumatoid Arthritis

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT05572567
Enrollment
1972
Registered
2022-10-07
Start date
2022-10-10
Completion date
2022-10-10
Last updated
2025-06-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Arthritis, Rheumatoid

Brief summary

This is a secondary structured database observational study conducted in Rheumatoid Arthritis (RA) patients treated with biologic and nonbiologic DMARDs, including tofacitinib, collected as part of the CorEvitas Japan RA Registry. The data as of September 2022 will be used for this study. The study will include data from March 2016 to the latest data cut available in 2022 for both effectiveness and safety outcomes.

Interventions

None listed

Sponsors

Pfizer
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
RETROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Diagnosed with Rheumatoid Arthritis (RA) according to the 1987 American College of Rheumatology (ACR) or the ACR/European Lead Against Rheumatism (EULAR) 2010 RA Classification Criteria; * At least 18 years of age or older; * Was / Must be prescribed or switching to the following eligible medication for the first time ever at the enrollment visit: * csDMARD: methotrexate (closed in February 2018); * Anti-TNF bDMARD: adalimumab (originator or biosimilar), certolizumab pegol, etanercept (originator or biosimilar), golimumab, infliximab (originator or biosimilar), or any other anti-TNF biosimilar approved during the study; * Non-TNF bDMARD: abatacept, tocilizumab, sarilumab (closed in June 2020); * JAK inhibitor: tofacitinib, baricitinib, peficitinib, filgotinib, upadacitinib.

Exclusion criteria

* Data that are prior to March 2016 and after June 2022

Design outcomes

Primary

MeasureTime frameDescription
Mean Incidence Rate of Total Herpes Zoster EventsRetrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)Incidence rate was defined as mean number of participants with total Herpes Zoster events per 100 person years. Total herpes zoster included both serious and non-serious herpes zoster events. Mean of incidence rate of total herpes zoster events was calculated and reported.
Mean Change From Baseline in Participant's Global Assessment at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)Participant's global assessment of disease activity on a 100 millimeter (mm) Visual Analog Scale (VAS) (scores ranging from 0 mm \[very well\] to 100 mm \[worst\], higher scores indicated worse health condition). Mean change from baseline was calculated by subtracting the baseline value from the 6-month value.
Mean Change From Baseline in Morning Stiffness at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)CDAI and other continuous measures like morning stiffness were represented as mean change from baseline to 6-months and were calculated by subtracting the baseline value from the 6-month value.
Mean Incidence Rate of Total Cardiovascular Disease (CVD) EventsRetrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)Incidence rate was defined as participants with total CVD events per (/) 100 person years. Total CVD was defined as hypertension requiring hospitalization, cardiac revascularization procedure (CABG, stent, angioplasty), ventricular arrhythmia, cardiac arrest, myocardial infarction, acute coronary syndrome, unstable angina, congestive heart failure (CHF) requiring hospitalization, stroke, transient ischemic attack, other cardiovascular event (specify), deep vein thrombosis, peripheral arterial thromboembolic event, urgent peripheral arterial revascularization, peripheral ischemia or gangrene (necrosis) and pulmonary embolism. Index visit was defined as the initiation date of the therapy of interest. Mean of incidence rate of total CVD events was calculated and reported.
Mean Incidence Rate of Serious Infections EventsRetrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)Incidence rate was defined as mean number of participants with serious infection events per 100 person years. Total serious infections were defined as infections meeting serious adverse event criteria or which required treatment with intravenous (IV) antibiotics. Serious infection types collected in the registry were pneumonia, sepsis, joint/bursa, cellulitis/skin, sinusitis, diverticulitis, bronchitis, gastroenteritis, meningitis/encephalitis, urinary tract infection, upper respiratory infection, active tuberculosis and other serious infections. Mean of incidence rate of total serious infection events was calculated and reported.
Mean Incidence Rate of Total Malignancy Excluding Non-Melanoma Skin Cancer (NMSC)Retrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)Incidence rate (number of participants with event per 100 person year) was defined as the mean number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. Total malignancy excluding non-melanoma skin cancer included lymphoma, lung cancer, breast cancer, skin cancer (melanoma), and other cancers. Mean of incidence rate of total malignancy excluding non-melanoma skin cancer was calculated and reported.
Mean Change From Baseline in Clinical Disease Activity Index (CDAI) at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)CDAI was the numerical sum of four outcome parameters: Tender joint count (TJC) or swollen joint count (SJC) both based on a 28-joint assessment, participant's assessment (PtGA) of disease activity and physician's global assessment (PGA) of disease activity both assessed on a 0 to 10 centimeter (cm) visual analogue scale (VAS) (higher scores indicated greater affection due to disease activity). CDAI total score ranged from 0 to 76. Higher scores indicated greater affection due to disease activity. CDAI less than or equal to (\<=) 2.8 indicated disease remission, greater than (\>) 2.8 to 10 indicated low disease activity, \>10 to 22 indicates moderate disease activity, and \>22 indicated high disease activity. Mean change from baseline was calculated by subtracting the baseline value from the 6-month value.
Mean Change From Baseline in Japanese Health Assessment Questionnaire (J-HAQ) at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)HAQ: participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom, arise, eat, walk, reach, grip, hygiene, and common activities over past week. Each item scored on 4-point scale, 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as sum of domain scores and divided by number of domains answered. Total possible score range 0-3: 0=least difficulty and 3=extreme difficulty. Higher scores indicated worse functioning. Mean change from baseline was calculated by subtracting the baseline value from the 6-month value.
Mean Change From Baseline in Participant's Pain at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)Participants were asked the following question to answer on a numeric rating scale (NRS): How much pain have you had because of your arthritis in the past week? The scale ranged from 0-100, where 0=no pain and 100=pain as bad as it could be. Higher scores indicated worsening of condition. Mean change from baseline in participant's pain was calculated and reported.
Mean Change From Baseline in Participant's Fatigue at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)Visual Analogue Scale (VAS) was a standardized tool for measuring overall health. Participants recorded their fatigue score on a range of 0 to 100, where higher score indicated higher intensity of fatigue. Mean change from baseline in participant's fatigue was calculated and reported.
Change in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)EQ-5D-5L was a participant rated questionnaire to assess health-related quality of life. It assessed level of current health in 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Each domain had 5 levels: 1= no problems, 2=slight problems, 3=moderate problems, 4=severe problems, or 5=extreme problems/unable to do task. Total score for each domain was from 1-5, where higher levels/scores indicated more difficulty in each domain. At baseline and 6 months, percentage of participants who recorded moderate, severe or extreme problems level in each of the domain were assessed; then change was calculated in percentage of participants from baseline at Month 6 and was reported in this outcome measure.
Percentage of Participants Who Achieved Minimally Clinically Important Difference (MCID) Improvement at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)MCID improvement assessed based on CDAI. CDAI: numerical sum of 4 outcome parameters: TJC and SJC based on a 28-joint assessment, PtGA and PGA assessed on 0-10 cm VAS; CDAI total score = 0-76, higher scores=greater affection due to disease activity (DA). CDAI \<= 2.8 indicates disease remission, \> 2.8 to 10 = low DA, \>10 to 22 = moderate DA, and \>22 = high DA. MCID improvement defined by difference in CDAI from baseline (at time of tofacitinib initiation) to 6-month visit.
Percentage of Participants Who Achieved Modified American College of Rheumatology (mACR) 20 Response Score at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)mACR20 response: \>= 20 percent (%) improvement in tender and swollen joint count and 20% improvement in 2 of the following 4 criteria: 1) participant assessment of pain (scored from 0 to 100, higher scores indicated worsening of pain); 2) participant global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 3) physician global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 4) self-assessed disability index of the j-HAQ (scored from 0 to 3, higher scores indicated worsening of function).
Percentage of Participants Who Achieved mACR 50 Response Score at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)mACR50 response: \>= 50% improvement in tender and swollen joint count and 50% improvement in 2 of the following 4 criteria: 1) participant assessment of pain (scored from 0 to 100, higher scores indicated worsening of pain); 2) participant global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 3) physician global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 4) self-assessed disability index of the j-HAQ (scored from 0 to 3, higher scores indicated worsening of function).
Percentage of Participants Who Achieved mACR 70 Response Score at 6 MonthsBaseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)mACR70 response: \>= 70% improvement in tender and swollen joint count and 70% improvement in 2 of the following 4 criteria: 1) participant assessment of pain (scored from 0 to 100, higher scores indicated worsening of pain); 2) participant global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 3) physician global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 4) self-assessed disability index of the j-HAQ (scored from 0 to 3, higher scores indicated worsening of function).

Countries

Japan

Participant flow

Recruitment details

This was a retrospective study of participants diagnosed with rheumatoid arthritis (RA) treated with biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs). Data was extracted from the CorEvitas Japan RA Registry from 01-Mar-2016 to 30-Jun-2022.

Participants by arm

ArmCount
Methotrexate
Data of participants who had moderate to severe RA and treated with methotrexate was collected as part of CorEvitas Japan RA Registry from 01 March-2016 to 30-Jun-2022 and observed in this study.
298
Tumor Necrosis Factor Inhibitors (TNFi)
Data of participants who had moderate to severe RA and treated with TNFi was collected as part of CorEvitas Japan RA Registry from 01 March-2016 to 30-Jun-2022 and observed in this study.
663
Non-TNFi
Data of participants who had moderate to severe RA and treated with non-TNFi was collected as part of CorEvitas Japan RA Registry from 01 March-2016 to 30-Jun-2022 and observed in this study.
758
Tofacitinib
Data of participants who had moderate to severe RA and treated with tofacitinib was collected as part of CorEvitas Japan RA Registry from 01 March-2016 to 30-Jun-2022 and observed in this study.
253
Total1,972

Baseline characteristics

CharacteristicMethotrexateTumor Necrosis Factor Inhibitors (TNFi)Non-TNFiTofacitinibTotal
Age, Continuous59.8 Years
STANDARD_DEVIATION 14
60.3 Years
STANDARD_DEVIATION 15.1
65.8 Years
STANDARD_DEVIATION 12.6
62.1 Years
STANDARD_DEVIATION 13.2
62.6 Years
STANDARD_DEVIATION 14
Race/Ethnicity, Customized
Japanese
295 Participants655 Participants750 Participants249 Participants1949 Participants
Race/Ethnicity, Customized
Unknown or not reported
3 Participants8 Participants8 Participants4 Participants23 Participants
Sex/Gender, Customized
Female
222 Participants538 Participants582 Participants208 Participants1550 Participants
Sex/Gender, Customized
Male
76 Participants125 Participants176 Participants45 Participants422 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 2980 / 6630 / 7580 / 253
other
Total, other adverse events
0 / 00 / 00 / 00 / 0
serious
Total, serious adverse events
0 / 00 / 00 / 00 / 0

Outcome results

Primary

Change in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6

EQ-5D-5L was a participant rated questionnaire to assess health-related quality of life. It assessed level of current health in 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Each domain had 5 levels: 1= no problems, 2=slight problems, 3=moderate problems, 4=severe problems, or 5=extreme problems/unable to do task. Total score for each domain was from 1-5, where higher levels/scores indicated more difficulty in each domain. At baseline and 6 months, percentage of participants who recorded moderate, severe or extreme problems level in each of the domain were assessed; then change was calculated in percentage of participants from baseline at Month 6 and was reported in this outcome measure.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureGroupValue (NUMBER)
MethotrexateChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Pain/discomfort-31.2 Percentage of participants
MethotrexateChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Selfcare-8.6 Percentage of participants
MethotrexateChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Depression/anxiety-9.5 Percentage of participants
MethotrexateChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Usual activities-12.6 Percentage of participants
MethotrexateChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Mobility-10.2 Percentage of participants
TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Usual activities-13.5 Percentage of participants
TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Pain/discomfort-24.6 Percentage of participants
TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Depression/anxiety-7.1 Percentage of participants
TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Selfcare-7.6 Percentage of participants
TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Mobility-6.8 Percentage of participants
Non-TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Usual activities-14.5 Percentage of participants
Non-TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Mobility-11.1 Percentage of participants
Non-TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Selfcare-12.2 Percentage of participants
Non-TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Pain/discomfort-28.5 Percentage of participants
Non-TNFiChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Depression/anxiety-9.5 Percentage of participants
TofacitinibChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Pain/discomfort-25.3 Percentage of participants
TofacitinibChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Selfcare-9 Percentage of participants
TofacitinibChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Mobility-10.8 Percentage of participants
TofacitinibChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Usual activities-14.8 Percentage of participants
TofacitinibChange in Percentage of Participants Reporting Moderate/Severe/Extreme Difficulty Levels for EQ-5D-5L From Baseline at Month 6Depression/anxiety-4.2 Percentage of participants
Primary

Mean Change From Baseline in Clinical Disease Activity Index (CDAI) at 6 Months

CDAI was the numerical sum of four outcome parameters: Tender joint count (TJC) or swollen joint count (SJC) both based on a 28-joint assessment, participant's assessment (PtGA) of disease activity and physician's global assessment (PGA) of disease activity both assessed on a 0 to 10 centimeter (cm) visual analogue scale (VAS) (higher scores indicated greater affection due to disease activity). CDAI total score ranged from 0 to 76. Higher scores indicated greater affection due to disease activity. CDAI less than or equal to (\<=) 2.8 indicated disease remission, greater than (\>) 2.8 to 10 indicated low disease activity, \>10 to 22 indicates moderate disease activity, and \>22 indicated high disease activity. Mean change from baseline was calculated by subtracting the baseline value from the 6-month value.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (MEAN)
MethotrexateMean Change From Baseline in Clinical Disease Activity Index (CDAI) at 6 Months-10.1 Units on a scale
TNFiMean Change From Baseline in Clinical Disease Activity Index (CDAI) at 6 Months-10.4 Units on a scale
Non-TNFiMean Change From Baseline in Clinical Disease Activity Index (CDAI) at 6 Months-11.5 Units on a scale
TofacitinibMean Change From Baseline in Clinical Disease Activity Index (CDAI) at 6 Months-11.7 Units on a scale
Primary

Mean Change From Baseline in Japanese Health Assessment Questionnaire (J-HAQ) at 6 Months

HAQ: participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom, arise, eat, walk, reach, grip, hygiene, and common activities over past week. Each item scored on 4-point scale, 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as sum of domain scores and divided by number of domains answered. Total possible score range 0-3: 0=least difficulty and 3=extreme difficulty. Higher scores indicated worse functioning. Mean change from baseline was calculated by subtracting the baseline value from the 6-month value.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (MEAN)
MethotrexateMean Change From Baseline in Japanese Health Assessment Questionnaire (J-HAQ) at 6 Months-0.3 Units on a scale
TNFiMean Change From Baseline in Japanese Health Assessment Questionnaire (J-HAQ) at 6 Months-0.2 Units on a scale
Non-TNFiMean Change From Baseline in Japanese Health Assessment Questionnaire (J-HAQ) at 6 Months-0.3 Units on a scale
TofacitinibMean Change From Baseline in Japanese Health Assessment Questionnaire (J-HAQ) at 6 Months-0.3 Units on a scale
Primary

Mean Change From Baseline in Morning Stiffness at 6 Months

CDAI and other continuous measures like morning stiffness were represented as mean change from baseline to 6-months and were calculated by subtracting the baseline value from the 6-month value.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (MEAN)
MethotrexateMean Change From Baseline in Morning Stiffness at 6 Months-31.5 Minutes
TNFiMean Change From Baseline in Morning Stiffness at 6 Months-22.4 Minutes
Non-TNFiMean Change From Baseline in Morning Stiffness at 6 Months-17.9 Minutes
TofacitinibMean Change From Baseline in Morning Stiffness at 6 Months-19.7 Minutes
Primary

Mean Change From Baseline in Participant's Fatigue at 6 Months

Visual Analogue Scale (VAS) was a standardized tool for measuring overall health. Participants recorded their fatigue score on a range of 0 to 100, where higher score indicated higher intensity of fatigue. Mean change from baseline in participant's fatigue was calculated and reported.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (MEAN)
MethotrexateMean Change From Baseline in Participant's Fatigue at 6 Months-13 Units on a scale
TNFiMean Change From Baseline in Participant's Fatigue at 6 Months-9.4 Units on a scale
Non-TNFiMean Change From Baseline in Participant's Fatigue at 6 Months-10.7 Units on a scale
TofacitinibMean Change From Baseline in Participant's Fatigue at 6 Months-15.5 Units on a scale
Primary

Mean Change From Baseline in Participant's Global Assessment at 6 Months

Participant's global assessment of disease activity on a 100 millimeter (mm) Visual Analog Scale (VAS) (scores ranging from 0 mm \[very well\] to 100 mm \[worst\], higher scores indicated worse health condition). Mean change from baseline was calculated by subtracting the baseline value from the 6-month value.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (MEAN)
MethotrexateMean Change From Baseline in Participant's Global Assessment at 6 Months-18.5 mm
TNFiMean Change From Baseline in Participant's Global Assessment at 6 Months-16.8 mm
Non-TNFiMean Change From Baseline in Participant's Global Assessment at 6 Months-16.1 mm
TofacitinibMean Change From Baseline in Participant's Global Assessment at 6 Months-19.5 mm
Primary

Mean Change From Baseline in Participant's Pain at 6 Months

Participants were asked the following question to answer on a numeric rating scale (NRS): How much pain have you had because of your arthritis in the past week? The scale ranged from 0-100, where 0=no pain and 100=pain as bad as it could be. Higher scores indicated worsening of condition. Mean change from baseline in participant's pain was calculated and reported.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (MEAN)
MethotrexateMean Change From Baseline in Participant's Pain at 6 Months-21.7 Units on a scale
TNFiMean Change From Baseline in Participant's Pain at 6 Months-17.6 Units on a scale
Non-TNFiMean Change From Baseline in Participant's Pain at 6 Months-17.4 Units on a scale
TofacitinibMean Change From Baseline in Participant's Pain at 6 Months-21.4 Units on a scale
Primary

Mean Incidence Rate of Serious Infections Events

Incidence rate was defined as mean number of participants with serious infection events per 100 person years. Total serious infections were defined as infections meeting serious adverse event criteria or which required treatment with intravenous (IV) antibiotics. Serious infection types collected in the registry were pneumonia, sepsis, joint/bursa, cellulitis/skin, sinusitis, diverticulitis, bronchitis, gastroenteritis, meningitis/encephalitis, urinary tract infection, upper respiratory infection, active tuberculosis and other serious infections. Mean of incidence rate of total serious infection events was calculated and reported.

Time frame: Retrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included. Here, 'Overall Number of Participants Analyzed' signifies participants evaluable for this outcome measure.

ArmMeasureValue (MEAN)
MethotrexateMean Incidence Rate of Serious Infections Events1.94 Participants with event/100 Person years
TNFiMean Incidence Rate of Serious Infections Events2.61 Participants with event/100 Person years
Non-TNFiMean Incidence Rate of Serious Infections Events5.02 Participants with event/100 Person years
TofacitinibMean Incidence Rate of Serious Infections Events3.1 Participants with event/100 Person years
Primary

Mean Incidence Rate of Total Cardiovascular Disease (CVD) Events

Incidence rate was defined as participants with total CVD events per (/) 100 person years. Total CVD was defined as hypertension requiring hospitalization, cardiac revascularization procedure (CABG, stent, angioplasty), ventricular arrhythmia, cardiac arrest, myocardial infarction, acute coronary syndrome, unstable angina, congestive heart failure (CHF) requiring hospitalization, stroke, transient ischemic attack, other cardiovascular event (specify), deep vein thrombosis, peripheral arterial thromboembolic event, urgent peripheral arterial revascularization, peripheral ischemia or gangrene (necrosis) and pulmonary embolism. Index visit was defined as the initiation date of the therapy of interest. Mean of incidence rate of total CVD events was calculated and reported.

Time frame: Retrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included. Here, 'Overall Number of Participants Analyzed' signifies participants evaluable for this outcome measure.

ArmMeasureValue (MEAN)
MethotrexateMean Incidence Rate of Total Cardiovascular Disease (CVD) Events0.51 Participants with event/100 Person years
TNFiMean Incidence Rate of Total Cardiovascular Disease (CVD) Events0.76 Participants with event/100 Person years
Non-TNFiMean Incidence Rate of Total Cardiovascular Disease (CVD) Events1.4 Participants with event/100 Person years
TofacitinibMean Incidence Rate of Total Cardiovascular Disease (CVD) Events1.54 Participants with event/100 Person years
Primary

Mean Incidence Rate of Total Herpes Zoster Events

Incidence rate was defined as mean number of participants with total Herpes Zoster events per 100 person years. Total herpes zoster included both serious and non-serious herpes zoster events. Mean of incidence rate of total herpes zoster events was calculated and reported.

Time frame: Retrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included. Here, 'Overall Number of Participants Analyzed' signifies participants evaluable for this outcome measure.

ArmMeasureValue (MEAN)
MethotrexateMean Incidence Rate of Total Herpes Zoster Events0.9 Participants with event/100 Person years
TNFiMean Incidence Rate of Total Herpes Zoster Events1.39 Participants with event/100 Person years
Non-TNFiMean Incidence Rate of Total Herpes Zoster Events2.18 Participants with event/100 Person years
TofacitinibMean Incidence Rate of Total Herpes Zoster Events8.07 Participants with event/100 Person years
Primary

Mean Incidence Rate of Total Malignancy Excluding Non-Melanoma Skin Cancer (NMSC)

Incidence rate (number of participants with event per 100 person year) was defined as the mean number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. Total malignancy excluding non-melanoma skin cancer included lymphoma, lung cancer, breast cancer, skin cancer (melanoma), and other cancers. Mean of incidence rate of total malignancy excluding non-melanoma skin cancer was calculated and reported.

Time frame: Retrospective data collection from index visit date up to follow-up or latest data cut on 30 June 2022 (Approximately up to 75 months)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included. Here, 'Overall Number of Participants Analyzed' signifies participants evaluable for this outcome measure.

ArmMeasureValue (MEAN)
MethotrexateMean Incidence Rate of Total Malignancy Excluding Non-Melanoma Skin Cancer (NMSC)1.72 Participants with event/100 Person years
TNFiMean Incidence Rate of Total Malignancy Excluding Non-Melanoma Skin Cancer (NMSC)1.71 Participants with event/100 Person years
Non-TNFiMean Incidence Rate of Total Malignancy Excluding Non-Melanoma Skin Cancer (NMSC)1.93 Participants with event/100 Person years
TofacitinibMean Incidence Rate of Total Malignancy Excluding Non-Melanoma Skin Cancer (NMSC)1.51 Participants with event/100 Person years
Primary

Percentage of Participants Who Achieved mACR 50 Response Score at 6 Months

mACR50 response: \>= 50% improvement in tender and swollen joint count and 50% improvement in 2 of the following 4 criteria: 1) participant assessment of pain (scored from 0 to 100, higher scores indicated worsening of pain); 2) participant global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 3) physician global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 4) self-assessed disability index of the j-HAQ (scored from 0 to 3, higher scores indicated worsening of function).

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (NUMBER)
MethotrexatePercentage of Participants Who Achieved mACR 50 Response Score at 6 Months35.9 Percentage of Participants
TNFiPercentage of Participants Who Achieved mACR 50 Response Score at 6 Months29.9 Percentage of Participants
Non-TNFiPercentage of Participants Who Achieved mACR 50 Response Score at 6 Months31.7 Percentage of Participants
TofacitinibPercentage of Participants Who Achieved mACR 50 Response Score at 6 Months33.2 Percentage of Participants
Primary

Percentage of Participants Who Achieved mACR 70 Response Score at 6 Months

mACR70 response: \>= 70% improvement in tender and swollen joint count and 70% improvement in 2 of the following 4 criteria: 1) participant assessment of pain (scored from 0 to 100, higher scores indicated worsening of pain); 2) participant global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 3) physician global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 4) self-assessed disability index of the j-HAQ (scored from 0 to 3, higher scores indicated worsening of function).

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (NUMBER)
MethotrexatePercentage of Participants Who Achieved mACR 70 Response Score at 6 Months21.4 Percentage of Participants
TNFiPercentage of Participants Who Achieved mACR 70 Response Score at 6 Months18.2 Percentage of Participants
Non-TNFiPercentage of Participants Who Achieved mACR 70 Response Score at 6 Months18.6 Percentage of Participants
TofacitinibPercentage of Participants Who Achieved mACR 70 Response Score at 6 Months22.4 Percentage of Participants
Primary

Percentage of Participants Who Achieved Minimally Clinically Important Difference (MCID) Improvement at 6 Months

MCID improvement assessed based on CDAI. CDAI: numerical sum of 4 outcome parameters: TJC and SJC based on a 28-joint assessment, PtGA and PGA assessed on 0-10 cm VAS; CDAI total score = 0-76, higher scores=greater affection due to disease activity (DA). CDAI \<= 2.8 indicates disease remission, \> 2.8 to 10 = low DA, \>10 to 22 = moderate DA, and \>22 = high DA. MCID improvement defined by difference in CDAI from baseline (at time of tofacitinib initiation) to 6-month visit.

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: Participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (NUMBER)
MethotrexatePercentage of Participants Who Achieved Minimally Clinically Important Difference (MCID) Improvement at 6 Months61.1 Percentage of Participants
TNFiPercentage of Participants Who Achieved Minimally Clinically Important Difference (MCID) Improvement at 6 Months57.6 Percentage of Participants
Non-TNFiPercentage of Participants Who Achieved Minimally Clinically Important Difference (MCID) Improvement at 6 Months65 Percentage of Participants
TofacitinibPercentage of Participants Who Achieved Minimally Clinically Important Difference (MCID) Improvement at 6 Months65.1 Percentage of Participants
Primary

Percentage of Participants Who Achieved Modified American College of Rheumatology (mACR) 20 Response Score at 6 Months

mACR20 response: \>= 20 percent (%) improvement in tender and swollen joint count and 20% improvement in 2 of the following 4 criteria: 1) participant assessment of pain (scored from 0 to 100, higher scores indicated worsening of pain); 2) participant global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 3) physician global assessment of disease activity (scored from 0 to 100, higher scores indicated worsening of condition); 4) self-assessed disability index of the j-HAQ (scored from 0 to 3, higher scores indicated worsening of function).

Time frame: Baseline, Month 6 (Retrospective data collection from 01 March-2016 to 30-Jun-2022)

Population: The participants who had RA and initiated treatment with methotrexate, tofacitinib, TNFi or non-TNFi and who were followed up after first dose of the drug were included.

ArmMeasureValue (NUMBER)
MethotrexatePercentage of Participants Who Achieved Modified American College of Rheumatology (mACR) 20 Response Score at 6 Months47.1 Percentage of Participants
TNFiPercentage of Participants Who Achieved Modified American College of Rheumatology (mACR) 20 Response Score at 6 Months39.8 Percentage of Participants
Non-TNFiPercentage of Participants Who Achieved Modified American College of Rheumatology (mACR) 20 Response Score at 6 Months45.6 Percentage of Participants
TofacitinibPercentage of Participants Who Achieved Modified American College of Rheumatology (mACR) 20 Response Score at 6 Months44.4 Percentage of Participants

Source: ClinicalTrials.gov · Data processed: Feb 6, 2026