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. 2025 Jan;137(1-2):49-55.
doi: 10.1007/s00508-024-02424-3. Epub 2024 Sep 11.

Obesity might not alter tofacitinib drug survival in rheumatoid arthritis patients

Esra Kayacan Erdoğan  1 , Berkan Armağan  2 , Rezan Koçak Ulucaköy  2 , Kevser Orhan  2 , Serdar Can Güven  2 , Bahar Özdemir Ulusoy  3 , Hatice Ecem Konak  2 , Özlem Karakaş  4 , Pınar Akyüz Dağlı  2 , Ebru Atalar  3 , İsmail Doğan  5 , Yüksel Maraş  6 , Ahmet Omma  6 , Orhan Küçükşahin  5 , Şükran Erten  5 , Hakan Babaoğlu  2
Affiliations

Obesity might not alter tofacitinib drug survival in rheumatoid arthritis patients

Esra Kayacan Erdoğan et al. Wien Klin Wochenschr. 2025 Jan.

Abstract

Introduction: Obese rheumatoid arthritis (RA) patients often show reduced responses to traditional treatments, including TNF inhibitors (TNFi). Considering the different mechanisms of action it is important to evaluate the efficacy of tofacitinib in obese patients. This study aims to explore the impact of obesity on the drug survival of tofacitinib in RA patients.

Material and methods: This retrospective cohort study included RA patients treated with tofacitinib. Patients were categorized into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups. The primary outcome was drug survival, assessed using Kaplan-Meier and logistic regression analyses.

Results: The study comprised 80 RA patients, with 31 (39%) classified as obese. At the 12-month mark, the drug survival rate for tofacitinib was higher in the obese group (81%) compared to the non-obese group (59%). Contrary to univariable analysis, multivariate analysis did not identify obesity as a significant predictor of drug survival. Other variables including sex, hypertension, diabetes mellitus, and anti-cyclic citrullinated peptide (anti-CCP) positivity also showed no significant association with tofacitinib drug survival.

Conclusion: The findings indicate that obesity does not alter the drug survival rate for tofacitinib among RA patients. Univariate analysis reported a potentially higher drug survival rate in obese patients; however, the lack of statistical significance in multivariate analysis and the study's retrospective nature necessitate further research to validate these observations and guide personalized therapeutic strategies for this population.

Keywords: Antirheumatic agents; Arthritis; Body mass index; Jak inhibitors; Withdrawal.

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Conflict of interest statement

Declarations. Conflict of interest: E. Kayacan Erdoğan, B. Armağan, R. Koçak Ulucaköy, K. Orhan, S. C. Güven, B. Özdemir Ulusoy, H. E. Konak, Ö. Karakaş, P. Akyüz Dağlı, E. Atalar, İ. Doğan, Y. Maraş, A. Omma, O. Küçükşahin, Ş. Erten and H. Babaoğlu declare that they have no competing interests. Ethical standards: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee Ankara Bilkent City Hospital approved the study protocol (Date = 06.09.2023, Ethical approval number = E1-22-3978).

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