Efficacy of tofacitinib, upadacitinib and olokizumab in rheumatoid arthritis in real clinical practice

• Published in: РМЖ: Медицинское обозрение Vol. 8; no. 2
• Main Authors: Lapkina, N.A., Baranov, A.A., Leont'eva, E.A., Amirdzhanova, V.N., Kolin'ko, A.A., Ashikhmin, G.M.
• Format: Journal Article
• Language: English
• Published: 2024
• ISSN: 2587-6821; 2686-9918
• DOI: 10.32364/2587-6821-2024-8-2-1

Aim: to perform an indirect comparative analysis of changes over time in clinical and laboratory parameters of inflammatory activity of rheumatoid arthritis (RA) in patients who receive tofacitinib (TOFA), upadacitinib (UPA), and olokizumab (OKZ) in real clinical practice. Patients and Methods: the study included 30 patients with advanced RA and moderate or high activity (DAS28-ESR score) who had ineffective prior therapy with methotrexate, leflunomide, or genetically engineered biological drugs for at least 6 months. The patients were divided into three groups: 10 patients received TOFA 5 mg twice daily, 10 patients received UPA 15 mg daily, and 10 patients received OCZ 64 mg subcutaneously every 4 weeks. The patients underwent examination before treatment, as well as after 3 and 6 months. The serum level of interleukin 6 (IL-6) was measured using multiplex xMAP technology on the Bio-PlexTM 200 System analyzer (BIO-RAD, USA). Results: treatment with TOFA, UPA, and OCZ was associated with a decrease in DAS28-ESR, CDAI, SDAI, and HAQ-DI scores after 3 months. After 6 months, UPA was found to be superior to TOFA in terms of reducing CDAI and SDAI. Treatment with TOFA resulted in a decrease in IL-6 levels after 3 and 6 months. The study found that UPA did not have an effect on IL-6 levels. However, therapy with OCZ resulted in an increase in IL-6 levels after 3 months, followed by a decrease after 6 months. Despite this, IL-6 levels did not return to baseline values. Conclusion: the results of the study suggest that there are differences in the clinical effects of Janus kinase (JAK) inhibitors and OCZ in RA patients. Nevertheless, all drugs were found to be effective in suppressing RA activity, regardless of baseline IL-6 levels and changes during treatment. KEYWORDS: rheumatoid arthritis, interleukin 6, tofacitinib, upadacitinib, olokizumab, disease activity, therapy efficacy. FOR CITATION: Lapkina N.A., Baranov A.A., Leont'eva E.A., Amirdzhanova V.N., Kolin'ko A.A., Ashikhmin G.M. Efficacy of tofacitinib, upadacitinib and olokizumab in rheumatoid arthritis in real clinical practice. Russian Medical Inquiry. 2024;8(2):51–59 (in Russ.). DOI: 10.32364/2587-6821-2024-8-2-1.