Evidence map›Paper›PMID 34429160›Full record

Trial reportArthritis research & therapy2021

Differences and similarities in clinical and functional responses among patients receiving tofacitinib monotherapy, tofacitinib plus methotrexate, and adalimumab plus methotrexate: a post hoc analysis of data from ORAL Strategy.

Tsutomu Takeuchi, Roy Fleischmann, Noriko Iikuni, Harry Shi, Koshika Soma, Jerome Paulissen, Tomohiro Hirose, Josef S Smolen

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
In one paragraph

Trial report in Arthritis research & therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02187055 (A Phase 3b/4 Randomized Double Blind Study Of 5 Mg Of Tofacitinib With And Without Methotrexate In Comparison To Adalimumab With Methotrexate In Subjects With Moderately To Severely Active Rheumatoid Arthritis), which is not on this map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02187055 phase4completednot on this map

A Phase 3b/4 Randomized Double Blind Study Of 5 Mg Of Tofacitinib With And Without Methotrexate In Comparison To Adalimumab With Methotrexate In Subjects With Moderately To Severely Active Rheumatoid Arthritis

TypeinterventionalSponsorPfizerRan2014 to 2016Enrolled1,152ConditionsRhematoid ArthritisArmsTofacitinib with methotrexate, Tofacitinib without methotrexate, Adalimumab with methotrexate
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 3 countries.

Tsutomu TakeuchiDivision of Rheumatology, Department of Internal Medicine, Keio University, Tokyo, Japan.
Roy FleischmannRheumatology Division, Metroplex Clinical Research Center and University of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0002-6630-1477
Noriko IikuniPfizer Inc, New York, NY, USA.ORCID 0000-0002-5541-9314
Harry ShiPfizer Inc, New York, NY, USA.
Koshika SomaPfizer Inc, Groton, CT, USA.
Jerome PaulissenPfizer Inc, New York, NY, USA.
Tomohiro HirosePfizer Japan Inc, Shinjuku Bunka Quint Building 22F, 3-22-7, Yoyogi, Shibuya-ku, Tokyo, 151-8589, Japan. tomohiro.hirose@pfizer.com.ORCID 0000-0002-9569-6834
Josef S SmolenDivision of Rheumatology and Department of Medicine 3, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-4302-8877
Pfizer (United States) · USKeio University · JPMedical University of Vienna · ATMetroplex Clinical Research Center · USPfizer (Japan) · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis post hoc analysis assessed clinical and functional responses to tofacitinib monotherapy, tofacitinib + methotrexate (MTX), and adalimumab + MTX, in patients with rheumatoid arthritis enrolled in the ORAL Strategy study, including evaluation of patient-level data using cumulative probability plots.

methodsIn the 12-month, phase IIIb/IV ORAL Strategy study, patients with rheumatoid arthritis and an inadequate response to MTX were randomized to receive tofacitinib 5 mg twice daily (BID), tofacitinib 5 mg BID + MTX, or adalimumab 40 mg every other week + MTX. In this post hoc analysis, cumulative probability plots were generated for mean percent change from baseline (%∆) in the Clinical Disease Activity Index (CDAI; clinical response) and mean change from baseline (∆) in the Health Assessment Questionnaire-Disability Index (HAQ-DI; functional response) at month 12. Median C-reactive protein (CRP) levels by time period were summarized by CDAI remission (≤ 2.8) status at months 6 and 12.

resultsData for 1146 patients were analyzed. At month 12, cumulative probability plots for %∆CDAI and ∆HAQ-DI were similar across treatments in patients with greater response. At lower levels of response, patients receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies. With tofacitinib + MTX, numerically higher baseline CRP levels and numerically larger post-baseline CRP reductions were seen in patients achieving CDAI remission at months 6 and 12 vs those who did not.

conclusionsThese results suggest that patients with a greater response did well, irrespective of which therapy they received. Patients with lesser response had better outcomes with combination therapies vs tofacitinib monotherapy, suggesting they benefitted from MTX. High pre-treatment CRP levels may be associated with better response to tofacitinib + MTX.

trial registrationClinicalTrials.gov, NCT02187055. Registered on 08 July 2014.

Indexed as

Antirheumatic AgentsMethotrexateAdalimumabDrug Therapy, CombinationHumansPiperidinesPyrimidinesPyrrolesTreatment OutcomeAdalimumabAntirheumatic AgentsMethotrexatePiperidinesPyrimidinesPyrrolestofacitinibAdalimumabMethotrexateRheumatoid arthritisTofacitinib

Identifiers

PMID34429160
PMCPMC8383419
OpenAlexW3193763526

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.