Loading...
Methotrexate is the standard of care for patients with rheumatoid arthritis. In addition to its use as monotherapy, methotrexate is the main ingredient in triple therapy (NEJM JW Gen Med Oct 23 2012) and combination therapy with biologics. However, concerns have been raised about its safety. In this industry-funded study, investigators randomized 958 patients who had not received methotrexate (or methotrexate in adequate doses) previously to either the oral kinase inhibitor tofacitinib (Xeljanz; 5 mg or 10 mg twice daily) or methotrexate (titrated to 20 mg weekly during 8 weeks).
At 6 months, radiographic outcomes favored the tofacitinib groups, but changes were modest in all three groups. However, ACR70 responses (i.e., American College of …