Tofacitinib versus Methotrexate in Rheumatoid Arthritis
In patients with rheumatoid arthritis, tofacitinib was associated with greater reductions in signs and symptoms than methotrexate. Herpes zoster infections and increases in creatinine and in LDL and HDL cholesterol levels were more common with tofacitinib. Rheumatoid arthritis is a chronic autoimmun...
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| Veröffentlicht in: | The New England journal of medicine 2014-06, Vol.370 (25), p.2377-2386 |
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| creator | Lee, Eun Bong Fleischmann, Roy Hall, Stephen Wilkinson, Bethanie Bradley, John D Gruben, David Koncz, Tamas Krishnaswami, Sriram Wallenstein, Gene V Zang, Chuanbo Zwillich, Samuel H van Vollenhoven, Ronald F |
| description | In patients with rheumatoid arthritis, tofacitinib was associated with greater reductions in signs and symptoms than methotrexate. Herpes zoster infections and increases in creatinine and in LDL and HDL cholesterol levels were more common with tofacitinib.
Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation and by joint destruction that leads to substantial disability. The predominant first-line treatment is methotrexate, a nonbiologic agent that is associated with acceptable clinical and functional improvements. Although methotrexate prevents progressive joint damage in some patients,
1
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3
concerns have been raised regarding its side effects and safety.
4
–
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In one study, discontinuation of methotrexate was reported after 2 years of treatment in one third of the patients and after 5 years of treatment in more than half the patients.
9
In combination with methotrexate, biologic disease-modifying antirheumatic drugs (DMARDs), including tumor . . . |
| doi_str_mv | 10.1056/NEJMoa1310476 |
| format | Article |
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Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation and by joint destruction that leads to substantial disability. The predominant first-line treatment is methotrexate, a nonbiologic agent that is associated with acceptable clinical and functional improvements. Although methotrexate prevents progressive joint damage in some patients,
1
–
3
concerns have been raised regarding its side effects and safety.
4
–
8
In one study, discontinuation of methotrexate was reported after 2 years of treatment in one third of the patients and after 5 years of treatment in more than half the patients.
9
In combination with methotrexate, biologic disease-modifying antirheumatic drugs (DMARDs), including tumor . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMoa1310476</identifier><identifier>PMID: 24941177</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Waltham, MA: Massachusetts Medical Society</publisher><subject><![CDATA[Administration, Oral ; Adult ; Antirheumatic Agents - administration & dosage ; Antirheumatic Agents - adverse effects ; Arthritis, Rheumatoid - blood ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - drug therapy ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; C-reactive protein ; Cancer ; Cholesterol ; Cholesterol - blood ; Creatinine ; Creatinine - blood ; Diseases of the osteoarticular system ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug therapy ; Enzyme inhibitors ; Erythrocyte sedimentation rate ; Female ; General aspects ; Herpes zoster ; Herpes Zoster - etiology ; Humans ; Inflammatory joint diseases ; Janus kinase ; Janus Kinase 3 - antagonists & inhibitors ; Joint diseases ; Kinases ; Lymphoma ; Male ; Medical sciences ; Methotrexate ; Methotrexate - administration & dosage ; Methotrexate - adverse effects ; Middle Aged ; Pain ; Pharmaceuticals ; Pharmacology. Drug treatments ; Piperidines - administration & dosage ; Piperidines - adverse effects ; Protein Kinase Inhibitors - administration & dosage ; Protein Kinase Inhibitors - adverse effects ; Pyrimidines - administration & dosage ; Pyrimidines - adverse effects ; Pyrroles - administration & dosage ; Pyrroles - adverse effects ; Rheumatism ; Rheumatoid arthritis]]></subject><ispartof>The New England journal of medicine, 2014-06, Vol.370 (25), p.2377-2386</ispartof><rights>Copyright © 2014 Massachusetts Medical Society. All rights reserved.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c568t-d823bf2d9283b6000b1f3ecfe26fbcfffe3f42a3427c8fc8bd26746037d643213</citedby><cites>FETCH-LOGICAL-c568t-d823bf2d9283b6000b1f3ecfe26fbcfffe3f42a3427c8fc8bd26746037d643213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMoa1310476$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.nejm.org/doi/full/10.1056/NEJMoa1310476$$EHTML$$P50$$Gmms$$H</linktohtml><link.rule.ids>230,314,550,776,780,881,2746,2747,26080,27901,27902,52357,54039</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28572809$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24941177$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:129231321$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Eun Bong</creatorcontrib><creatorcontrib>Fleischmann, Roy</creatorcontrib><creatorcontrib>Hall, Stephen</creatorcontrib><creatorcontrib>Wilkinson, Bethanie</creatorcontrib><creatorcontrib>Bradley, John D</creatorcontrib><creatorcontrib>Gruben, David</creatorcontrib><creatorcontrib>Koncz, Tamas</creatorcontrib><creatorcontrib>Krishnaswami, Sriram</creatorcontrib><creatorcontrib>Wallenstein, Gene V</creatorcontrib><creatorcontrib>Zang, Chuanbo</creatorcontrib><creatorcontrib>Zwillich, Samuel H</creatorcontrib><creatorcontrib>van Vollenhoven, Ronald F</creatorcontrib><creatorcontrib>ORAL Start Investigators</creatorcontrib><title>Tofacitinib versus Methotrexate in Rheumatoid Arthritis</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>In patients with rheumatoid arthritis, tofacitinib was associated with greater reductions in signs and symptoms than methotrexate. Herpes zoster infections and increases in creatinine and in LDL and HDL cholesterol levels were more common with tofacitinib.
Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation and by joint destruction that leads to substantial disability. The predominant first-line treatment is methotrexate, a nonbiologic agent that is associated with acceptable clinical and functional improvements. Although methotrexate prevents progressive joint damage in some patients,
1
–
3
concerns have been raised regarding its side effects and safety.
4
–
8
In one study, discontinuation of methotrexate was reported after 2 years of treatment in one third of the patients and after 5 years of treatment in more than half the patients.
9
In combination with methotrexate, biologic disease-modifying antirheumatic drugs (DMARDs), including tumor . . .</description><subject>Administration, Oral</subject><subject>Adult</subject><subject>Antirheumatic Agents - administration & dosage</subject><subject>Antirheumatic Agents - adverse effects</subject><subject>Arthritis, Rheumatoid - blood</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>C-reactive protein</subject><subject>Cancer</subject><subject>Cholesterol</subject><subject>Cholesterol - blood</subject><subject>Creatinine</subject><subject>Creatinine - blood</subject><subject>Diseases of the osteoarticular system</subject><subject>Dose-Response Relationship, Drug</subject><subject>Double-Blind Method</subject><subject>Drug therapy</subject><subject>Enzyme inhibitors</subject><subject>Erythrocyte sedimentation rate</subject><subject>Female</subject><subject>General aspects</subject><subject>Herpes zoster</subject><subject>Herpes Zoster - etiology</subject><subject>Humans</subject><subject>Inflammatory joint diseases</subject><subject>Janus kinase</subject><subject>Janus Kinase 3 - antagonists & inhibitors</subject><subject>Joint diseases</subject><subject>Kinases</subject><subject>Lymphoma</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methotrexate</subject><subject>Methotrexate - administration & dosage</subject><subject>Methotrexate - adverse effects</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Pharmaceuticals</subject><subject>Pharmacology. Drug treatments</subject><subject>Piperidines - administration & dosage</subject><subject>Piperidines - adverse effects</subject><subject>Protein Kinase Inhibitors - administration & dosage</subject><subject>Protein Kinase Inhibitors - adverse effects</subject><subject>Pyrimidines - administration & dosage</subject><subject>Pyrimidines - adverse effects</subject><subject>Pyrroles - administration & dosage</subject><subject>Pyrroles - adverse effects</subject><subject>Rheumatism</subject><subject>Rheumatoid arthritis</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>D8T</sourceid><recordid>eNp10ctLHDEYAPBQLN3V9uhVBkTwMm1ek2SOsqy2RSuIPYdM5gubdWeyJjM-_vtmcevWgrkkhB_fE6FDgr8SXIlvv-Y_r4IhjGAuxQc0JRVjJedY7KEpxlSVXNZsgvZTWuJ8CK8_oQnlNSdEyimSt8EZ6wff-6Z4gJjGVFzBsAhDhCczQOH74mYBY2eG4NviLA6LmHX6jD46s0rwZXsfoN_n89vZ9_Ly-uLH7OyytJVQQ9kqyhpH25oq1oicvyGOgXVAhWuscw6Y49QwTqVVzqqmpUJygZlsBWeUsANUvsRNj7AeG72OvjPxWQfj9fbrLr9AVxSrauNPX_w6hvsR0qA7nyysVqaHMCadx1Nzoeq6yvT4P7oMY-xzNxslVSWl_KcAG0NKEdxrCQTrzQb0mw1kf7SNOjYdtK_678gzONkCk6xZuWh669PO5bxU4Xrnui7pHpbdOwn_AOyfmNI</recordid><startdate>20140619</startdate><enddate>20140619</enddate><creator>Lee, Eun Bong</creator><creator>Fleischmann, Roy</creator><creator>Hall, Stephen</creator><creator>Wilkinson, Bethanie</creator><creator>Bradley, John D</creator><creator>Gruben, David</creator><creator>Koncz, Tamas</creator><creator>Krishnaswami, Sriram</creator><creator>Wallenstein, Gene V</creator><creator>Zang, Chuanbo</creator><creator>Zwillich, Samuel H</creator><creator>van Vollenhoven, Ronald F</creator><general>Massachusetts Medical Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20140619</creationdate><title>Tofacitinib versus Methotrexate in Rheumatoid Arthritis</title><author>Lee, Eun Bong ; Fleischmann, Roy ; Hall, Stephen ; Wilkinson, Bethanie ; Bradley, John D ; Gruben, David ; Koncz, Tamas ; Krishnaswami, Sriram ; Wallenstein, Gene V ; Zang, Chuanbo ; Zwillich, Samuel H ; van Vollenhoven, Ronald F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c568t-d823bf2d9283b6000b1f3ecfe26fbcfffe3f42a3427c8fc8bd26746037d643213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Administration, Oral</topic><topic>Adult</topic><topic>Antirheumatic Agents - administration & dosage</topic><topic>Antirheumatic Agents - adverse effects</topic><topic>Arthritis, Rheumatoid - blood</topic><topic>Arthritis, Rheumatoid - complications</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>C-reactive protein</topic><topic>Cancer</topic><topic>Cholesterol</topic><topic>Cholesterol - blood</topic><topic>Creatinine</topic><topic>Creatinine - blood</topic><topic>Diseases of the osteoarticular system</topic><topic>Dose-Response Relationship, Drug</topic><topic>Double-Blind Method</topic><topic>Drug therapy</topic><topic>Enzyme inhibitors</topic><topic>Erythrocyte sedimentation rate</topic><topic>Female</topic><topic>General aspects</topic><topic>Herpes zoster</topic><topic>Herpes Zoster - etiology</topic><topic>Humans</topic><topic>Inflammatory joint diseases</topic><topic>Janus kinase</topic><topic>Janus Kinase 3 - antagonists & inhibitors</topic><topic>Joint diseases</topic><topic>Kinases</topic><topic>Lymphoma</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methotrexate</topic><topic>Methotrexate - administration & dosage</topic><topic>Methotrexate - adverse effects</topic><topic>Middle Aged</topic><topic>Pain</topic><topic>Pharmaceuticals</topic><topic>Pharmacology. Drug treatments</topic><topic>Piperidines - administration & dosage</topic><topic>Piperidines - adverse effects</topic><topic>Protein Kinase Inhibitors - administration & dosage</topic><topic>Protein Kinase Inhibitors - adverse effects</topic><topic>Pyrimidines - administration & dosage</topic><topic>Pyrimidines - adverse effects</topic><topic>Pyrroles - administration & dosage</topic><topic>Pyrroles - adverse effects</topic><topic>Rheumatism</topic><topic>Rheumatoid arthritis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Eun Bong</creatorcontrib><creatorcontrib>Fleischmann, Roy</creatorcontrib><creatorcontrib>Hall, Stephen</creatorcontrib><creatorcontrib>Wilkinson, Bethanie</creatorcontrib><creatorcontrib>Bradley, John D</creatorcontrib><creatorcontrib>Gruben, David</creatorcontrib><creatorcontrib>Koncz, Tamas</creatorcontrib><creatorcontrib>Krishnaswami, Sriram</creatorcontrib><creatorcontrib>Wallenstein, Gene V</creatorcontrib><creatorcontrib>Zang, Chuanbo</creatorcontrib><creatorcontrib>Zwillich, Samuel H</creatorcontrib><creatorcontrib>van Vollenhoven, Ronald F</creatorcontrib><creatorcontrib>ORAL Start Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Eun Bong</au><au>Fleischmann, Roy</au><au>Hall, Stephen</au><au>Wilkinson, Bethanie</au><au>Bradley, John D</au><au>Gruben, David</au><au>Koncz, Tamas</au><au>Krishnaswami, Sriram</au><au>Wallenstein, Gene V</au><au>Zang, Chuanbo</au><au>Zwillich, Samuel H</au><au>van Vollenhoven, Ronald F</au><aucorp>ORAL Start Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tofacitinib versus Methotrexate in Rheumatoid Arthritis</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2014-06-19</date><risdate>2014</risdate><volume>370</volume><issue>25</issue><spage>2377</spage><epage>2386</epage><pages>2377-2386</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>In patients with rheumatoid arthritis, tofacitinib was associated with greater reductions in signs and symptoms than methotrexate. Herpes zoster infections and increases in creatinine and in LDL and HDL cholesterol levels were more common with tofacitinib.
Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation and by joint destruction that leads to substantial disability. The predominant first-line treatment is methotrexate, a nonbiologic agent that is associated with acceptable clinical and functional improvements. Although methotrexate prevents progressive joint damage in some patients,
1
–
3
concerns have been raised regarding its side effects and safety.
4
–
8
In one study, discontinuation of methotrexate was reported after 2 years of treatment in one third of the patients and after 5 years of treatment in more than half the patients.
9
In combination with methotrexate, biologic disease-modifying antirheumatic drugs (DMARDs), including tumor . . .</abstract><cop>Waltham, MA</cop><pub>Massachusetts Medical Society</pub><pmid>24941177</pmid><doi>10.1056/NEJMoa1310476</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0028-4793 1533-4406 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; SWEPUB Freely available online; New England Journal of Medicine |
| subjects | Administration, Oral Adult Antirheumatic Agents - administration & dosage Antirheumatic Agents - adverse effects Arthritis, Rheumatoid - blood Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - drug therapy Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents C-reactive protein Cancer Cholesterol Cholesterol - blood Creatinine Creatinine - blood Diseases of the osteoarticular system Dose-Response Relationship, Drug Double-Blind Method Drug therapy Enzyme inhibitors Erythrocyte sedimentation rate Female General aspects Herpes zoster Herpes Zoster - etiology Humans Inflammatory joint diseases Janus kinase Janus Kinase 3 - antagonists & inhibitors Joint diseases Kinases Lymphoma Male Medical sciences Methotrexate Methotrexate - administration & dosage Methotrexate - adverse effects Middle Aged Pain Pharmaceuticals Pharmacology. Drug treatments Piperidines - administration & dosage Piperidines - adverse effects Protein Kinase Inhibitors - administration & dosage Protein Kinase Inhibitors - adverse effects Pyrimidines - administration & dosage Pyrimidines - adverse effects Pyrroles - administration & dosage Pyrroles - adverse effects Rheumatism Rheumatoid arthritis |
| title | Tofacitinib versus Methotrexate in Rheumatoid Arthritis |
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