Background/Purpose:

Several previous reports suggest that obesity impairs the effectiveness and drug survival of anti-TNF-α agents in rheumatoid arthritis (RA). The aim of the study was to analyze the impact of obesity on drug survival of tofacitinib in patient with RA, based on their baseline body mass index (BMI).

Methods:

Data on patient characteristics, demographics, diagnosis, disease duration, treatment and outcomes have been collected since 2011 in Turkish Biologic (TURKBIO) Registry. By the end of May 2018, 140 RA patients received tofacitinib and were included. Demographic and clinical data including age, sex, disease type, disease duration and previous or current treatment with DMARDs and biological drug durations are stored in the database. Kaplan-Meier survival analysis was performed to estimate the drug survival.

Results:

All patients received tofacitinib 5 mg BID. Patients were grouped according to BMI. Forty-eight were obese (BMI >30), 92 were non-obese patients.  Obese patients were found to be older, had more DM and HT compared to non-obese patients as expected (Table 1). Gender distribution, disease duration, serologic positivity, previous or current treatment with DMARDs, previous TNH inhibitor or non-TNF biological drug use, concomitant prednisolone use and mean clinical and laboratory parameters through the observation period did not differ between groups. Tofacitinib treatment was ongoing in 59.8% in non-obese and 70.8% in obese patients. Median drug survival duration was 10 months in non-obese patients and 24 months in obese ones (p=0.1). Estimated drug survival rates for tofacitinib were not statistically significantly different between groups (Figure 1).

Conclusion:

 Real life experience from this nationwide TURKBIO registry suggests obesity does not adversely affect drug survival of tofacitinib in patients with RA. Further studies are needed to study impact of obesity on its clinical efficacy.