Tofacitinib (TOF) is a small-molecule medication taken orally to treat rheumatoid arthritis (RA). It is numerous alternatives to tumor necrosis factor inhibitors (TNFi). Using real-world data from the Ontario Best Practices Research Initiative, researchers compared the efficacy of TNFi to TOF based on Ontario Best Practices Research Initiative (OBRI).

Patients recruited in the OBRI between 2014 and 2019 who began TOF or TNFi were included. Patients were required to have a physician- and patient-reported efficacy outcome data, such as the Clinical Disease Activity Index (CDAI) and the RA Disease Activity Index (RADAI), accessible at the start of therapy and 6 (± 2) months later. They calculated propensity scores (PS) for variables to account for confounding by indication.

About 419 people were enrolled in the study. There were 226 TNFi patients and 193 TOF patients, with a mean (SD) illness duration of 8.0 (8.7) and 12.6 (9.6) years, respectively. Furthermore, compared to the TOF group (67.9%), the TNFi group was less likely to have prior biologic usage (21.7%). At 6 months, the proportion of patients in CDAI low disease activity (LDA)/remission (REM) was 36.7% in the TNFi group and 33.2% in the TOF group, respectively. The generalized linear mixed models adjusted for PS quantile revealed no significant difference between the two groups in CDAI LDA/REM (odds ratio [OR] 0.85, 95% CI 0.51-1.43) and RADAI coefficient (OR 0.48, 95% CI -0.18 to 1.14).

After 6 months following therapy, physician- and patient-reported efficacy in individuals with RA was comparable in the TNFi and TOF groups.