mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2021-3-35-42mrj-1145Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSСравнительная эффективность тофацитиниба и адалимумаба у пациентов с псориатическим артритом в реальной клинической практике. Данные Общероссийского регистра пациентов с псориатическим артритомComparative efficacy of tofacitinib and adalimumab in patients with psoriatic arthritis in real clinical practice. Data from the Russian nationwide register of patients with psoriatic arthritishttps://orcid.org/0000-0001-6875-4552ЛогиноваЕ. Ю.LoginovaE. Yu.

Елена Юрьевна Логинова

Россия, 115522, Москва, Каширское шоссе, 34А

Elena Yurievna Loginiva

34A, Kashirskoe Shosse, Moscow 115522, Russia

eyloginova@mail.ruhttps://orcid.org/0000-0003-0579-1131КоротаеваТ. В.KorotaevaT. V.

Россия, 115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0001-5015-7143ГубарьЕ. Е.GubarE. E.

Россия, 115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0001-5968-2403КорсаковаЮ. Л.KorsakovaYu. L.

Россия, 115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0002-4285-0869ГлуховаС. И.GlukhovaS. I.

Россия, 115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0003-2153-5429ВасиленкоЕ. А.VasilenkoE. A.

Россия, 191015, Санкт-Петербург, ул. Кирочная, 41

41, Kirochnaya st., St. Petersburg 191015, Russia

https://orcid.org/0000-0002-5486-2576ВасиленкоА. А.VasilenkoA. A.

173008, Россия, Великий Новгород, ул. Павла Левитта, 14

14, Pavla Levitta st., Veliky Novgorod 173008, Russia

https://orcid.org/0000-0002-4972-7716КузнецоваН. А.KuznetsovaN. A.

620102, Екатеринбург, ул. Волгоградская, 189

189, Volgogradskaya st., Ekaterinburg 620102, Russia

https://orcid.org/0000-0003-0530-0080ПатрикееваИ. М.PatrikeyevaI. M.

625023, Тюмень, ул. Котовского, 55

55, Kotovskogo st., Tyumen 625023, Russia

https://orcid.org/0000-0002-1598-8360НасоновЕ. Л.NasonovE. L.

Россия, 115522, Москва, Каширское шоссе, 34А

119991, Москва, ул. Трубецкая, 8, стр.2

34A, Kashirskoe Shosse, Moscow 115522, Russia

8, Trubetskaya St., Build. 2, Moscow 119991, Russia

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова»РоссияNorth-Western State Medical University named after I.I. MechnikovRussian FederationГОБУЗ «Новгородская областная клиническая больница»РоссияNovgorod Regional Clinical HospitalRussian FederationМАУЗ «Городская клиническая больница №40»РоссияCity Clinical Hospital №40Russian FederationГБУЗ Тюменской области «Областная клиническая больница №1»РоссияRegional Clinical Hospital №1Russian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияV.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation20212306202115335–42Copyright © Логинова Е.Ю., Коротаева Т.В., Губарь Е.Е., Корсакова Ю.Л., Глухова С.И., Василенко Е.А., Василенко А.А., Кузнецова Н.А., Патрикеева И.М., Насонов Е.Л., 20212021Логинова Е.Ю., Коротаева Т.В., Губарь Е.Е., Корсакова Ю.Л., Глухова С.И., Василенко Е.А., Василенко А.А., Кузнецова Н.А., Патрикеева И.М., Насонов Е.Л.Loginova E.Y., Korotaeva T.V., Gubar E.E., Korsakova Y.L., Glukhova S.I., Vasilenko E.A., Vasilenko A.A., Kuznetsova N.A., Patrikeyeva I.M., Nasonov E.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1145

Цель исследования – сравнение клинической эффективности таргетного синтетического базисного противовоспалительного препарата (тсБПВП) тофацитиниба (ТОФА) и генно-инженерного биологического препарата (ГИБП), ингибитора фактора некроза опухоли α (иФНОα) адалимумаба (АДА) у больных псориатическим артритом (ПсА) в реальной клинической практике по данным Общероссийского регистра пациентов с ПсА.

Пациенты и методы

Пациенты и методы. В исследование включено 77 больных ПсА (43 мужчины и 34 женщины), соответствовавших критериям CASPAR и наблюдавшихся в Общероссийском регистре. Пациенты были разделены на две группы в зависимости от проводимого лечения. В 1-ю группу, в которой назначали таблетированный ТОФА по 5 мг 2 раза в день, вошел 41 пациент: 24 (58,5%) мужчины и 17 (41,5%) женщин, медиана возраста – 41 [34; 50] год, медиана длительности ПсА – 72 [35; 120] мес. Ко 2-й группе, в которой использовали АДА по 40 мг/2 нед подкожно, отнесены 36 больных: 19 (52,8%) мужчин и 17 (47,2%) женщин, медиана возраста – 44 [34; 51] года, медиана длительности ПсА – 59 [22; 102] мес. Комбинированную терапию, включавшую метотрексат (МТ), получали 80,5% пациентов группы ТОФА и 52,8% пациента группы АДА. У всех пациентов в начале исследования и каждые 6 мес оценивали активность и эффективность терапии ПсА по DAPSA и критериям минимальной активности болезни – MAБ (число болезненных суставов ≤1, число припухших суставов ≤1, PASI ≤1 или BSA ≤3, оценка боли ≤15, общая оценка активности болезни больным ≤20 мм по визуальной аналоговой шкале, HAQ ≤0,5, энтези- ты ≤1), динамику BASDAI и BSA. Определяли число больных, достигших ремиссии (DAPSA ≤4) или МАБ (5 критериев из 7) на фоне терапии ТОФА и АДА.

Результаты и обсуждение

Результаты и обсуждение. До начала терапии в 1-й группе медиана DAPSA составляла 44,2 [37,8; 55,3]: умеренная активность ПсА была у 5 (12,2%), высокая – у 36 (87,8%) больных. Во 2-й группе медиана DAPSA равнялась 35,8 [21,1; 52]: низкая активность выявлена у 3 (8,6%), умеренная – у 11 (31,4%), высокая – у 21 (60%) больного (доступны данные 35 пациентов). Через 6 мес после начала лечения у пациентов 1-й и 2-й групп произошло значимое снижение всех показателей активности ПсА по сравнению с исходными. Мeдиана DAPSA составила соответственно 11 [4,3; 17,3] и 9,1 [6; 19,6]; ремиссии по DAPSA достигли соответственно 11 (26,8%) и 6 (20,8%) больных, низкой активности – 15 (36,6%) и 13 (44,8%), МАБ – 16 (40%) и 9 (30%). Число пациентов с дактилитом значимо уменьшилось: с 22 (53,7%) до 5 (13,2%) и с 13 (36,1%) до 6 (20%) соответственно в 1-й и 2-й группах. Мeдиана HAQ снизилась с 1 [0,625; 1,5] дo 0,5 [0; 0,875] и с 0,875 [0,5; 1,38] дo 0,5 [0; 0,875]; мeдиана BASDAI – с 6 [4,2; 7] дo 1,4 [0,6; 3,2] и с 4,4 [1,9; 5,8] дo 3 [0,8; 4,5] соответственно. В 1-й группе число пациентов с BSA >3% сократилось с 16 (39%) до 8 (26,7%; p<0,225), а во 2-й группе из-за недостаточного объема данных (5 пациентов) динамику BSA оценить не удалось.

Заключение

Заключение. Показана сопоставимая эффективность ТОФА и АДА в реальной клинической практике в отношении всех клинических проявлений ПсА: через 6 мес терапии у большинства пациентов с ПсА отмечено достижение МАБ, низкой активности болезни и ремиссии по DAPSA и BASDAI.

Objective

Objective: to compare the clinical efficacy in real clinical practice of the targeted synthetic disease-modifying antirheumatic drug (sDMARD) tofacitinib (TOFA) and the biologic DMARD (bDMARD), an inhibitor of tumor necrosis factor alpha (TNFα), adalimumab (ADA) in patients with psoriatic arthritis (PsA), included in the Russian nationwide register of patients with PsA.

Patients and methods

Patients and methods. The study included 77 patients with PsA (43 men and 34 women) who met the CASPAR criteria and were observed in the Russian nationwide register. Patients were divided into two groups depending on the treatment. Group 1, in which oral TOFA was prescribed, 5 mg 2 times a day, included 41 patients: 24 (58.5%) men and 17 (41.5%) women, the median age was 41 [34; 50] years, the median duration of PsA was 72 [35; 120] months. Group 2, in which subcutaneous ADA was used, 40 mg every 2 weeks, included 36 patients: 19 (52.8%) men and 17 (47.2%) women, the median age was 44 [34; 51] years, the median duration of PsA was 59 [22; 102] months. Combination therapy, including methotrexate (MT), received 80.5% of patients in the TOFA group and 52.8% of patients in the ADA group. At the beginning of the study and every 6 months further, the activity and efficacy of PsA therapy were assessed in all patients according to DAPSA and criteria for minimal disease activity – MDA (number of painful joints ≤1, number of swollen joints ≤1, PASI ≤1 or BSA ≤3 , pain score ≤15, patient's general assessment of disease activity ≤20 mm on a visual analogue scale, HAQ ≤0.5, enthesitis ≤1), dynamics of BASDAI and BSA were also assessed. The number of patients who achieved remission (DAPSA ≤4) or MDA (5 criteria out of 7) during therapy with TOFA and ADA was determined.

Results and discussion

Results and discussion. Before the start of the therapy in the 1st group, the median DAPSA was 44.2 [37.8; 55.3]: moderate PsA activity was in 5 (12.2%) patients, high in 36 (87.8%) patients. In group 2, the median DAPSA was 35.8 [21.1; 52]: low activity was detected in 3 (8.6%), moderate – in 11 (31.4%), high – in 21 (60%) patients (data from 35 patients was available). 6 months after the start of treatment in patients of the 1st and the 2nd group, there was a significant decrease in all indicators of PsA activity compared to the baseline. The median DAPSA was 11 [4.3; 17.3] and 9.1 [6; 19.6]; remissions according to DAPSA reached 11 (26.8%) and 6 (20.8%) patients, respectively, low activity – 15 (36.6%) and 13 (44.8%), MDA – 16 (40%) and 9 (30%). The number of patients with dactylitis in the 1st and in the 2nd group significantly decreased: from 22 (53.7%) to 5 (13.2%) and from 13 (36.1%) to 6 (20%), respectively. Median HAQ decreased from 1 [0.625; 1.5] to 0.5 [0; 0.875] and from 0.875 [0.5; 1.38] to 0.5 [0; 0.875]; median BASDAI – from 6 [4.2; 7] to 1.4 [0.6; 3.2] and from 4.4 [1.9; 5.8] to 3 [0.8; 4.5], respectively. In group 1, the number of patients with BSA> 3% decreased from 16 (39%) to 8 (26.7%; p<0.225), and in group 2, due to insufficient data (5 patients), we failed to evaluate BSA dynamics.

Conclusion

Conclusion. In real clinical practice TOFA and ADA both had comparable efficacy on all clinical manifestations of PsA: after 6 months of therapy, most patients with PsA achieved MDA, low disease activity and remission according to DAPSA and BASDAI.

псориатический артриттофацитинибадалимумабгенно-инженерные биологические препаратытаргетные синтетические базисные противовоспалительные препаратыремиссияминимальная активность болезниpsoriatic arthritistofacitinibadalimumabbiologic disease-modifying antirheumatic drugtargeted synthetic disease-modifying antirheumatic drugremissionminimal disease activityReferencesGladman DD, Antoni C, Mease P, et al. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis. 2005 Mar;64 Suppl 2(Suppl 2):ii14-7. doi: 10.1136/ard.2004.032482.Gladman DD, Antoni C, Mease P, et al. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis. 2005 Mar;64 Suppl 2(Suppl 2):ii14-7. doi: 10.1136/ard.2004.032482.Coates LC, Kavanaugh A, Mease PJ, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol. 2016 May;68(5):1060-71. doi: 10.1002/art.39573. Epub 2016 Mar 23.Coates LC, Kavanaugh A, Mease PJ, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol. 2016 May;68(5):1060-71. doi: 10.1002/art.39573. Epub 2016 Mar 23.Gossec L, Baraliakos X, Kerschbaumer A, et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):700-12. doi: 10.1136/annrheumdis-2020-217159.Gossec L, Baraliakos X, Kerschbaumer A, et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):700-12. doi: 10.1136/annrheumdis-2020-217159.Murray K, Turk M, Alammari Y, et al. Long-term remission and biologic persistence rates: 12-year real-world data. Arthritis Res Ther. 2021 Jan 13;23(1):25. doi: 10.1186/s13075-020-02380-z.Murray K, Turk M, Alammari Y, et al. Long-term remission and biologic persistence rates: 12-year real-world data. Arthritis Res Ther. 2021 Jan 13;23(1):25. doi: 10.1186/s13075-020-02380-z.Haddad A, Gazitt T, Feldhamer I, et al. Treatment persistence of biologics among patients with psoriatic arthritis. Arthritis Res Ther. 2021 Jan 29;23(1):44. doi: 10.1186/s13075-021-02417-x.Haddad A, Gazitt T, Feldhamer I, et al. Treatment persistence of biologics among patients with psoriatic arthritis. Arthritis Res Ther. 2021 Jan 29;23(1):44. doi: 10.1186/s13075-021-02417-x.Merola JF, Lockshin B, Mody EA. Switching biologics in the treatment of psoriatic arthritis. Semin Arthritis Rheum. 2017 Aug; 47(1):29-37. doi: 10.1016/j.semarthrit.2017.02.001. Epub 2017 Feb 8.Merola JF, Lockshin B, Mody EA. Switching biologics in the treatment of psoriatic arthritis. Semin Arthritis Rheum. 2017 Aug; 47(1):29-37. doi: 10.1016/j.semarthrit.2017.02.001. Epub 2017 Feb 8.Choy E. Clinical significance of Janus Kinase inhibitor selectivity. Rheumatology (Oxford). 2020 Mar 1;59(3):487-94. doi: 10.1093/rheumatology/kez664.Choy E. Clinical significance of Janus Kinase inhibitor selectivity. Rheumatology (Oxford). 2020 Mar 1;59(3):487-94. doi: 10.1093/rheumatology/kez664.Virtanen AT, Haikarainen T, Raivola J, Silvennoinen O. Selective JAKinibs: prospects in Inflammatory and Autoimmune diseases. BioDrugs. 2019 Feb;33(1):15-32. doi: 10.1007/s40259-019-00333-w.Virtanen AT, Haikarainen T, Raivola J, Silvennoinen O. Selective JAKinibs: prospects in Inflammatory and Autoimmune diseases. BioDrugs. 2019 Feb;33(1):15-32. doi: 10.1007/s40259-019-00333-w.Colbert RA, Ward MM. JAK inhibitors taking on psoriatic arthritis. N Engl J Med. 2017 Oct 19;377(16):1582-4. doi: 10.1056/NEJMe1709907.Colbert RA, Ward MM. JAK inhibitors taking on psoriatic arthritis. N Engl J Med. 2017 Oct 19;377(16):1582-4. doi: 10.1056/NEJMe1709907.Mease P, Hall S, Fitzgerald O, et al. Tofacitinib or adalimumab versus placebo for psoriatic arthritis. N Engl J Med. 2017 Oct 19; 377(16):1537-50. doi: 10.1056/NEJMoa1615975.Mease P, Hall S, Fitzgerald O, et al. Tofacitinib or adalimumab versus placebo for psoriatic arthritis. N Engl J Med. 2017 Oct 19; 377(16):1537-50. doi: 10.1056/NEJMoa1615975.Gladman D, Rigby W, Azevedo VF, et al. Tofacitinib for psoriatic arthritis in patients with an inadequate response to TNF inhibitors. N Engl J Med. 2017 Oct 19;377(16):1525-36. doi: 10.1056/NEJMoa1615977.Gladman D, Rigby W, Azevedo VF, et al. Tofacitinib for psoriatic arthritis in patients with an inadequate response to TNF inhibitors. N Engl J Med. 2017 Oct 19;377(16):1525-36. doi: 10.1056/NEJMoa1615977.Nash P, Coates LC, Fleischmann R, et al. Efficacy of Tofacitinib for the Treatment of Psoriatic Arthritis: Pooled Analysis of Two Phase 3 Studies. Rheumatol Ther. 2018 Dec; 5(2):567-82. doi: 10.1007/s40744-018-0131-5. Epub 2018 Nov 9.Nash P, Coates LC, Fleischmann R, et al. Efficacy of Tofacitinib for the Treatment of Psoriatic Arthritis: Pooled Analysis of Two Phase 3 Studies. Rheumatol Ther. 2018 Dec; 5(2):567-82. doi: 10.1007/s40744-018-0131-5. Epub 2018 Nov 9.Castro S, Masmitja J, Carlos M. Efficacy of Tofacitinib in the Treatment of Psoriatic Arthritis: A Systematic Review. Adv Ther. 2021 Feb;38(2):868-84. doi: 10.1007/s12325-020-01585-7. Epub 2020 Dec 17.Castro S, Masmitja J, Carlos M. Efficacy of Tofacitinib in the Treatment of Psoriatic Arthritis: A Systematic Review. Adv Ther. 2021 Feb;38(2):868-84. doi: 10.1007/s12325-020-01585-7. Epub 2020 Dec 17.Насонов ЕЛ. Новые подходы к фармакотерапии ревматоидного артрита: тофацитиниб. Научно-практическая ревматология. 2014;52(2):209-21.Nasonov EL. New approaches to the pharmacotherapy of rheumatoid arthritis: tofacitinib. Nauchno-prakticheskaya revmatologiya. 2014;52(2):209-21. (In Russ.).Dhillon S. Tofacitinib: A Review in Rheumatoid Arthritis. Drugs. 2017 Dec;77(18): 1987-2001. doi: 10.1007/s40265-017-0835-9.Dhillon S. Tofacitinib: A Review in Rheumatoid Arthritis. Drugs. 2017 Dec;77(18): 1987-2001. doi: 10.1007/s40265-017-0835-9.Berekmeri A, Mahmood F, Wittmann M, Helliwell P. Tofacitinib for the treatment of psoriasis and psoriatic arthritis. Expert Rev Clin Immunol. 2018 Sep;14(9):719-30. doi: 10.1080/1744666X.2018.1512404.Berekmeri A, Mahmood F, Wittmann M, Helliwell P. Tofacitinib for the treatment of psoriasis and psoriatic arthritis. Expert Rev Clin Immunol. 2018 Sep;14(9):719-30. doi: 10.1080/1744666X.2018.1512404.Логинова ЕЮ, Корсакова ЮЛ, Губарь ЕЕ и др. Эффективность и безопасность то- фацитиниба у больных псориатическим артритом в реальной клинической практике. Научно-практическая ревматология. 2020;58(3):268-75.Loginova EYu, Korsakova YuL, Gubar' EE, et al. Efficacy and safety of tofacitinib in patients with psoriatic arthritis in real clinical practice. Nauchno-prakticheskaya revmatologiya. 2020;58(3):268-75. (In Russ.).Helliwell P, Coates LC, FitzGerald O, et al. Disease-specific composite measures for psoriatic arthritis are highly responsive to a Janus kinase inhibitor treatment that targets multiple domains of disease. Arthritis Res Ther. 2018 Oct 29;20(1):242. doi: 10.1186/s13075-018-1739-0.Helliwell P, Coates LC, FitzGerald O, et al. Disease-specific composite measures for psoriatic arthritis are highly responsive to a Janus kinase inhibitor treatment that targets multiple domains of disease. Arthritis Res Ther. 2018 Oct 29;20(1):242. doi: 10.1186/s13075-018-1739-0.Smolen JS, Mease P, Tahir H, et al. Multicentre, randomised, open-label, parallel- group study evaluating the efficacy and safety of ixekizumab versus adalimumab in patients with psoriatic arthritis naive to biological disease-modifying antirheumatic drug: final results by week 52. Ann Rheum Dis. 2020 Oct;79(10):1310-19. doi: 10.1136/annrheumdis-2020-217372. Epub 2020 Jul 13.Smolen JS, Mease P, Tahir H, et al. Multicentre, randomised, open-label, parallel- group study evaluating the efficacy and safety of ixekizumab versus adalimumab in patients with psoriatic arthritis naive to biological disease-modifying antirheumatic drug: final results by week 52. Ann Rheum Dis. 2020 Oct;79(10):1310-19. doi: 10.1136/annrheumdis-2020-217372. Epub 2020 Jul 13.McInnes IB, Behrens F, Mease PJ, et al. Secukinumab versus adalimumab for treatment of active psoriatic arthritis (EXCEED): a double-blind, parallel-group, randomised, active-controlled, phase 3b trial. Lancet. 2020 May 9;395(10235):1496-505. doi: 10.1016/S0140-6736(20)30564-X.McInnes IB, Behrens F, Mease PJ, et al. Secukinumab versus adalimumab for treatment of active psoriatic arthritis (EXCEED): a double-blind, parallel-group, randomised, active-controlled, phase 3b trial. Lancet. 2020 May 9;395(10235):1496-505. doi: 10.1016/S0140-6736(20)30564-X.Mease P, Gladman DD, Collier DH, et al. Etanercept and Methotrexate as Monotherapy or in Combination for Psoriatic Arthritis: Primary Results From a Randomized, Controlled Phase III Trial. Arthritis Rheumatol. 2019 Jul;71(7):1112-24. doi: 10.1002/art.40851. Epub 2019 May 28.Mease P, Gladman DD, Collier DH, et al. Etanercept and Methotrexate as Monotherapy or in Combination for Psoriatic Arthritis: Primary Results From a Randomized, Controlled Phase III Trial. Arthritis Rheumatol. 2019 Jul;71(7):1112-24. doi: 10.1002/art.40851. Epub 2019 May 28.Lu C, Wallaceb BI, Waljee AK, et al. Comparative efficacy and safety of targeted DMARDs for active psoriatic arthritis during induction therapy: A systematic review and network meta-analysis. Semin Arthritis Rheum. 2019 Dec;49(3):381-8. doi: 10.1016/j.semarthrit.2019.06.001. Epub 2019 Jun 10.Lu C, Wallaceb BI, Waljee AK, et al. Comparative efficacy and safety of targeted DMARDs for active psoriatic arthritis during induction therapy: A systematic review and network meta-analysis. Semin Arthritis Rheum. 2019 Dec;49(3):381-8. doi: 10.1016/j.semarthrit.2019.06.001. Epub 2019 Jun 10.Deodhar A, Sliwinska-Stanczyk P, Xu H, et al. Tofacitinib for the treatment of ankylosing spondylitis: a phase III, randomised, double- blind, placebocontrolled study. Ann Rheum Dis. 2021 Apr 27;annrheumdis-2020-219601. doi: 10.1136/annrheumdis-2020-219601. Online ahead of print.Deodhar A, Sliwinska-Stanczyk P, Xu H, et al. Tofacitinib for the treatment of ankylosing spondylitis: a phase III, randomised, double- blind, placebocontrolled study. Ann Rheum Dis. 2021 Apr 27;annrheumdis-2020-219601. doi: 10.1136/annrheumdis-2020-219601. Online ahead of print.Gubar E, Korotaeva T, Korsakova Y, et al. Effect of tofacitinib treatment on active MRI sacroiliitis and disease activity reduction in psoriatic arthritis patients. Data from clinical practice. Ann Rheum Dis. 2020;79:1162.Gubar E, Korotaeva T, Korsakova Y, et al. Effect of tofacitinib treatment on active MRI sacroiliitis and disease activity reduction in psoriatic arthritis patients. Data from clinical practice. Ann Rheum Dis. 2020;79:1162.www.pfizer.com/news/press-release/press-release-detail/pfizer-shares-co-primary-endpoint-results-post-marketingwww.pfizer.com/news/press-release/press-release-detail/pfizer-shares-co-primary-endpoint-results-post-marketingИнструкция по медицинскому применению препарата тофацитиниб (Яквинус) № ЛП-002026-200820.Instructions for the medical use of the tofacitinib (Yaquinus) № LP-002026-200820.

The authors declare that there are no conflicts of interest present.