Rheumatoid Arthritis (RA) (see Rheumatoid Arthritis, [[Rheumatoid Arthritis]]): demonstrated to improve control over that of methotrexate alone (see Methotrexate, [[Methotrexate]]) [MEDLINE]
Used with/without methotrexate or other disease modifying agents
Contraindications
Concomitant Use of Azathioprine (Imuran) (see Azathioprine, [[Azathioprine]])
Concomitant Use of Cyclosporine A (see Cyclosporine A, [[Cyclosporine A]])
Testing for Viral Hepatitis: patient with hepatitis B/C were excluded from trials, so the effect of tofacitinib on viral reactivation of hepatitis B/C is unknown
Elevated Liver Function Tests (LFT’s) (see xxxx, [[]])
Intestinal Perforation (see Intestinal Perforation, [[Intestinal Perforation]]): although this has been reported in clinical trials, the etiologic role of tofacitinib is unknown
Infectious Adverse Effects
Increased Risk of Tuberculosis (see Tuberculosis, [[Tuberculosis]]) [MEDLINE]
Especially with concomitant use of other immunospppressants (such as methotrexate) and corticosteroids
Increased Risk of Invasive Fungal Infections: especially with concomitant use of other immunospppressants (such as methotrexate) and corticosteroids
Increased Risk of Other Opportunistic Infections: especially with concomitant use of other immunospppressants (such as methotrexate) and corticosteroids
Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: a randomised phase 3 trial. Lancet. 2013 Feb 9;381(9865):451-60 [MEDLINE]
Tofacitinib in Combination With Nonbiologic Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis: A Randomized Trial. Ann Intern Med. 2013;159(4):253-261 [MEDLINE]