Tofacitinib

Tofacitinib is a small molecule Janus kinase (JAK) inhibitor that modulates intracellular signaling pathways involved in the inflammatory process. In rheumatology, tofacitinib is primarily used for the treatment of autoimmune diseases, particularly those involving chronic inflammation and joint damage.

The main indications of tofacitinib in rheumatology include:

  • Rheumatoid arthritis: Tofacitinib is indicated for the treatment of moderate to severe rheumatoid arthritis in adults who have not responded adequately to, or are intolerant of, methotrexate or other disease-modifying antirheumatic drugs (DMARDs). It can be used as monotherapy or in combination with methotrexate or other non-biologic DMARDs.
  • Psoriatic arthritis: Tofacitinib is also approved for the treatment of active psoriatic arthritis in adults who have had an inadequate response to, or are intolerant of, methotrexate or other DMARDs.
  • Ankylosing spondylitis: Although not as widely studied as in rheumatoid arthritis and psoriatic arthritis, tofacitinib has shown promising results in the treatment of ankylosing spondylitis, particularly in patients who have not responded adequately to conventional therapy.

Tofacitinib is administered orally and is available in tablet form. The recommended dosage varies depending on the specific indication and patient factors. It is important to note that tofacitinib carries warnings regarding serious infections, malignancies, and thrombosis, so its use should be carefully monitored by a rheumatologist. Additionally, regular monitoring of blood counts, liver function tests, and lipid levels is recommended during treatment with tofacitinib.