Comparative Efficacy of Janus Kinase Inhibitor (Tofacitinib) in Treatment and Disease Activity of Ankylosing Spondylitis

Asim  Mushtaq; Amer  Fakhr; Bilal  Rasheed; Ishfaq Ahmed; Farzana Hakim; Ghulam Abbas Khan Niazi

doi:10.51253/pafmj.v76iSUPPL-6.12458

Authors

Asim Mushtaq Department of Rheumatology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Amer Fakhr Department of Rheumatology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Bilal Rasheed Department of Rheumatology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Ishfaq Ahmed Department of Rheumatology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Farzana Hakim Department of Biochemistry, Foundation University Medical College, Islamabad Pakistan
Ghulam Abbas Khan Niazi Department of Rheumatology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-6.12458

Keywords:

Ankylosing Spondylitis, Etanercept, Janus Kinase Inhibitors, Schober’s Test, Tofacitinib

Abstract

Objective: To investigate the effectiveness of Janus Kinase Inhibitor (Tofacitinib) given in the treatment and disease activity of ankylosing spondylitis patients.

Study Design: Quasi-Experimental Study.

Place and Duration of Study: Rheumatology Department, Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Mar to May 2023.

Methodology: Patients of either gender aged 25 to 60 years diagnosed with axSpA for at least 1 year with inadequate response to NSAIDs, lifestyle modification, exercise, and physiotherapy, and naïve to a bDMARD or JAK inhibitor were included. Patients were divided into two groups, I and II, in a ratio of 1:1 based on patient preference and clinical judgement of the treating physician. Group-I was given NSAIDs + Tofacitinib, while Group-II received NSAIDs + Etanercept. Pre- and post-treatment at 3-month clinical and inflammatory parameters, including Schober`s test, BASDAI score, ESR, CRP, and platelet count, were noted and compared for drug response.

Results: A total of 224 patients with ankylosing spondylitis having a median age of 47.00 (12.00) years, were included, with 117(52.2%) males and 107(47.8%) females. The pre-treatment Schober`s test, platelet count, and CRP were noted, which were statistically insignificant in both groups (p=0.948, p=0.504, and p=0.804, respectively. As per baseline BASDAI score, overall, 58(51.12%) was in acute flare, and 120(53.57%) patients had high/extremely high disease activity. At 3-month Tofacitinib Group showed slightly better improvement in Schober’s test as compared to Etanercept Group (p<0.001)...

Conclusion: The Tofacitinib Group had slightly better disease control in terms of pain, rotation of movement, and improvement in quality of life.

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