Evidence map›Paper›PMID 39066962›Full record

ArticleRheumatology and therapy2024

Methotrexate, Tofacitinib, and Biologic Disease-Modifying Antirheumatic Drug Safety and Effectiveness Among Patients with Rheumatoid Arthritis in Japan: CorEvitas Registry Observational Study.

Yoshiya Tanaka, Mitsumasa Kishimoto, Koshiro Sonomoto, Koichi Amano, Masayoshi Harigai, Alina Onofrei, Jacqueline O'Brien, Zachary Margolin, Christine Barr, Yasushi Mizuno and 3 more

Registry-linked trialAbstract read
In one paragraph

Article in Rheumatology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05572567 (An Observational Study Within the CorEvitas Registry to Evaluate Safety and Effectiveness of Tofacitinib and Biologic Disease Modifying Antirheumatic Drugs), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT05572567 completednot on this map

An Observational Study Within the CorEvitas Registry to Evaluate Safety and Effectiveness of Tofacitinib and Biologic Disease Modifying Antirheumatic Drugs (bDMARDs) in Japan Among Patients Treated for Moderately to Severely Active Rheumatoid Arthritis

TypeobservationalSponsorPfizerRan2022 to 2022Enrolled1,972ConditionsArthritis, Rheumatoid
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
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

13 authors.

Yoshiya TanakaThe First Department of Internal Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan. tanaka@med.uoeh-u.ac.jp.ORCID http://orcid.org/0000-0002-0807-7139
Mitsumasa KishimotoDepartment of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan.ORCID http://orcid.org/0000-0002-4007-1589
Koshiro SonomotoDepartment of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan.ORCID http://orcid.org/0000-0002-4003-8842
Koichi AmanoDepartment of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.ORCID http://orcid.org/0000-0002-4228-2056
Masayoshi HarigaiDivision of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.ORCID http://orcid.org/0000-0002-6418-2603
Alina OnofreiCorEvitas, LLC, Waltham, MA, USA.
Jacqueline O'BrienCorEvitas, LLC, Waltham, MA, USA.ORCID http://orcid.org/0009-0002-4998-5747
Zachary MargolinCorEvitas, LLC, Waltham, MA, USA.ORCID http://orcid.org/0000-0003-2600-0511
Christine BarrCorEvitas, LLC, Waltham, MA, USA.
Yasushi MizunoPfizer Japan Inc, Tokyo, Japan.
Ekta AgarwalPfizer, Inc, New York, NY, USA.
Naonobu SugiyamaPfizer Japan Inc, Tokyo, Japan.ORCID http://orcid.org/0000-0002-5008-0665
Hisashi YamanakaSanno Medical Center, Tokyo, Japan.ORCID http://orcid.org/0000-0001-8453-6731

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe evolution of disease-modifying antirheumatic drugs (DMARDs) for the treatment of rheumatoid arthritis (RA) has improved patient prognosis. However, more real-world safety/effectiveness data comparing methotrexate (MTX), tofacitinib, tumor necrosis factor inhibitors (TNFi), and non-TNFi biologic DMARDs (bDMARDs) are warranted.

methodsThe CorEvitas RA Japan registry was used to identify patients with rheumatologist-diagnosed RA who initiated MTX/tofacitinib/TNFi/non-TNFi bDMARDs. Safety outcomes included incidence of major adverse cardiovascular events (MACE), total cardiovascular disease, total serious infections, total herpes zoster, and total malignancies (excluding non-melanoma skin cancer). Effectiveness outcomes included change from baseline (Δ) in Clinical Disease Activity Index (CDAI) and proportion of patients achieving a minimum clinically important difference (MCID) in CDAI at month 6. Adjusted regression models were fit; marginal means were estimated.

resultsOverall, 1972 patients were included in the safety cohort: MTX (N = 298); tofacitinib (N = 253); TNFi (N = 663); non-TNFi (N = 758). Mean follow-up time was 3.8, 2.9, 3.0, and 2.9 years for MTX, tofacitinib, TNFi, and non-TNFi, respectively. Adjusted incidence rates (IRs, patients with events/100 patient-years [95% confidence intervals]) for MACE and total cardiovascular disease, respectively, were numerically lower for MTX (0.34 [0, 0.83]; 0.42 [0, 0.92]) and TNFi (0.09 [0, 0.27]; 0.61 [0.15, 1.07]) versus tofacitinib (0.48 [0, 1.20]; 2.30 [0.38, 4.22]) and non-TNFi (0.77 [0.35, 1.19]; 1.28 [0.73, 1.82]). Serious infections were numerically higher for non-TNFi (4.47 [3.38, 5.56]); herpes zoster was higher for tofacitinib (7.41 [4.52, 10.29]), versus other groups. IRs for malignancies were comparable between groups. Mean ΔCDAI and rates of achieving MCID in CDAI at month 6 were generally greater with tofacitinib versus other groups.

conclusionSome variations in incidence of safety outcomes were observed between treatments, while certain effectiveness outcomes favored tofacitinib. Sample size variation between groups and low number of safety events limited the analysis. Further studies are warranted to investigate observed differences. CLINICALTRIALS: GOV: NCT05572567.

Indexed as

EffectivenessInfectionMACEMalignancyReal-worldRegistryRheumatoid arthritisSafetyTofacitinib

Identifiers

PMID39066962
PMCPMC11422330

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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.