Patients suffering from rheumatoid arthritis are treated for around six months with the standard anti-rheumatic agent methotrexate, to which many patients respond very well.
However, if they do not respond and no remission, or at least reduction, in the activity of the disease can be achieved, they are given a combined treatment of methotrexate and a biologic agent (frequently an anti-TNF, such as adalimumab, administered by injection), if risk factors are present.
An international research group has now shown that there is another, equally effective oral treatment option: the combination of methotrexate and the chemically synthesised Janus Kinase Inhibitor tofacitinib. The results of the study, for which MedUni Vienna Rheumatologist, Josef Smolen, was senior author, have now been published in the medical journal, The Lancet.
Smolen, Head of the Division of Rheumatology at MedUni Vienna, and researchers from America, Argentina, Australia, the UK, and China, were able to demonstrate that the combination of methotrexate / tofacitinib produced equally effective results as the current standard combination of methotrexate/ adalimumab. The latter has to be injected into patients every two weeks, whereas the new option involves taking two tablets a day – a potential advantage for patients. A total of just over 1,100 volunteers were involved in the study.
Smolen explained, ‘At the same time we were able to show that monotherapy with tofacitinib does not achieve such good results as combined therapy with methotrexate, even though it is still quite effective.’