Tofacitinib in Rheumatoid Arthritis: Is There a Correlation Between a Rapid Analgesic Effect and a Decrease in Activity After 3 and 6 Months?

Elena Pogozheva¹, Andrey Karateev¹, Evgeniy Nasonov¹, Alexander Lila¹, Vadim Mazurov², Rusanna Samigullina³, Diana Chakieva⁴, Anna Dadalova⁴, Anna Dyo⁴, Andrey Baranov⁵, Natalia Lapkina⁵, Ekaterina Kol’tsova⁶, Ivan Shchendrigin⁷, Tatyana Rasevich⁸, Antonina Davydova⁹, Irina Shafieva¹⁰, Inna Bashkova¹¹, Daria Bobrikova¹², Irina Kushnir¹³, Elena Kalinina¹⁴, Tatiana Sal’nikova¹⁵, Valentina Sorotskaya¹⁶, Irina Marusenko¹⁷, Olga Semagina¹⁸, Irina Vinogradova¹⁹, Diana Krechikova²⁰, Natalia Kiryukhina²¹, Irina Semizarova²², Dzhamilya Murtazalieva²³ and Marina Semchenkova²⁴, ¹V.A. Nasonova Reseach Institute of Rheumatology, Moscow, Russia, ²Mechnikov North-Western State Medical University, Saint Petersburg, Russia, ³Mechnikov North-Western State Medical University, St.Petersburg, Russia, ⁴Mechnikov North-Western State Medical University, St. Petersburg, Russia, ⁵Yaroslavl State Medical University, Yaroslavl, Russia, ⁶Scientific and Research Institute of Health Care Organization, Moscow, Russia, ⁷Stavropol Regional Clinical Hospital, Stavropol, Russia, ⁸Astrakhan Region Alexandro-Mariinsky Regional Clinical Hospital, Astrakhan, Russia, ⁹Regional Clinical Hospital №1 named. prof. S. V. Ochapovskogo, Krasnodar, Russia, ¹⁰Samara State Medical University of the Ministry of Health of the Russian Federation, Samara, Russia, ¹¹Advisory Polyclinic Chuvash State University named after I. N. Ulyanov, Cheboksary, Russia, ¹²Regional Clinical Hospital No. 1, Tyumen', Russia, ¹³Kemerovo regional clinical hospital, Kemerovo, Russia, ¹⁴Volgograd State Medical University, Volgograd, Russia, ¹⁵Regional Clinical Hospital, Tula, Russia, ¹⁶Tula State Medical University, Tula, Russia, ¹⁷Petrozavodsk State University, Petrozavodsk, Russia, ¹⁸Regional Clinical Hospital, Samara, Russia, ¹⁹Regional Clinical Hospital, Ulyanovsk, Russia, ²⁰Smolensk State Medical University, Smolensk, Russia, ²¹National Medical and Surgical Center named after N.I. Pirogov” of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, ²²Regional Clinical Hospital, Krasnodar, Russia, ²³Moscow Clinical Scientific and Practical Centre named after Loginov A.S., Moscow, Russia, ²⁴Medical Clinical Centre, Smolensk, Russia

Meeting: ACR Convergence 2021

Keywords: central sensitization, Disease Activity, pain, rheumatoid arthritis, Tofacitinib

Session Information

Date: Tuesday, November 9, 2021

Session Title: RA – Treatments Poster III: RA Treatments & Their Safety (1674–1710)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: to investigate the correlation between the rapid analgesic effect of tofacitinib and a decrease in RA activity after 3 and 6 months.

Methods: The study group consisted of 88 RA patients, age 53±11.5, 79.3% women, 89.8% RF “+”, DAS28 5.2±1.2, who received DMARDs (59.5% methotrexate and 19.8% leflunomide), who had ineffectiveness or intolerance to biological therapy. All patients were prescribed tofacitinib 10 mg / day. The severity of pain was assessed using the Brief pain inventory (BPI) questionnaire, the presence of a neuropathic pain component (NPC) using the painDETECT questionnaire, and signs of central sensitization (CS) using the Central Sensitivity Inventory (CSI) questionnaire in the early stages after tofacitinib administration, and RA activity by DAS28 at 3 and 6 months.

Results: Pain intensity at baseline was 5.3±2.0 on the visual analog scale (VAS 0-10), 51.1% of patients had signs of central sensitization (CSI ≥ 40), 15.9% had NPC (painDETECT ≥18). 7 days after starting tofacitinib, there was a statistically significant decrease in pain intensity – to 4.1±1.8 (p< 0.05) and CS-CSI from 40.4±13.5 to 36.5±12.5 (p=0.01). After 28 days, the pain intensity (VAS) was 2.8±1.6 (p=0.000), painDETECT decreased from 11.8±5.6 to 6.8± 3.1 (p=0.000), CSI to 31.6±13.9 (p=0.000). DAS28 after 3 and 6 months was 3.7±1.3 and 3.6±1.2. The number of patients with pain reduction ≥ 50% after 28 days of therapy was 59.9%. Low RA activity after 3 months (DAS28 ≤3.2) was achieved in 64.4% of patients. This was a clear correlation between the number of patients with significant pain reduction after 28 days and the number of patients who achieved low RA activity after 3 and 6 months (rS=0.548, p=0.000; rS=0.790, p=0.000). 6 patients dropped out of the study due to inefficiency or social reasons. No serious adverse reactions were observed.

Conclusion: Tofacitinib rapidly reduces the intensity of pain and signs of CS in RA. A quick response to this drug (pain reduction) makes it possible to predict a decrease in RA activity after 3 and 6 months of therapy.

Disclosures: E. Pogozheva, None; A. Karateev, None; E. Nasonov, Eli Lilly, 2, Abbvie, 2, Pfizer, 2, Hoffmann-La Roche, 2, Biocad, 2, R-Pharm, 2; A. Lila, None; V. Mazurov, None; R. Samigullina, None; D. Chakieva, None; A. Dadalova, None; A. Dyo, None; A. Baranov, None; N. Lapkina, None; E. Kol’tsova, None; I. Shchendrigin, None; T. Rasevich, None; A. Davydova, None; I. Shafieva, None; I. Bashkova, None; D. Bobrikova, None; I. Kushnir, None; E. Kalinina, None; T. Sal’nikova, None; V. Sorotskaya, None; I. Marusenko, None; O. Semagina, None; I. Vinogradova, None; D. Krechikova, None; N. Kiryukhina, None; I. Semizarova, None; D. Murtazalieva, None; M. Semchenkova, None.

To cite this abstract in AMA style:

Pogozheva E, Karateev A, Nasonov E, Lila A, Mazurov V, Samigullina R, Chakieva D, Dadalova A, Dyo A, Baranov A, Lapkina N, Kol’tsova E, Shchendrigin I, Rasevich T, Davydova A, Shafieva I, Bashkova I, Bobrikova D, Kushnir I, Kalinina E, Sal’nikova T, Sorotskaya V, Marusenko I, Semagina O, Vinogradova I, Krechikova D, Kiryukhina N, Semizarova I, Murtazalieva D, Semchenkova M. Tofacitinib in Rheumatoid Arthritis: Is There a Correlation Between a Rapid Analgesic Effect and a Decrease in Activity After 3 and 6 Months? [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/tofacitinib-in-rheumatoid-arthritis-is-there-a-correlation-between-a-rapid-analgesic-effect-and-a-decrease-in-activity-after-3-and-6-months/. Accessed October 4, 2022.

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