Generally, an anti-rheumatic agent methotrexate is used to treat patients who have rheumatoid arthritis for around six months. The response of several patients was very well to this treatment. In case the patients do not respond, and no remission is seen, or at least a decrease in the action of the disease can be obtained. They were then provided with combined treatment of methotrexate and a biologic agent (frequently an anti-TNF, such as e.g. adalimumab injection), if risk factors were observed. An international research group demonstrated the availability of an equally effective oral treatment option. It is a combination of methotrexate and the chemically synthesised Janus Kinase Inhibitor tofacitinib. The results of the study, have now been published in the top medical journal. In this study over 1,100 volunteers were involved. The researchers explained that the combination of methotrexate/tofacitinib produced equally effective results as the current standard combination of methotrexate/adalimumab. The latter combination needed to be injected into patients every two weeks.

Tofacitinib as an "enzyme inhibitor" It possesses the property of inhibiting particular enzymes (Janus Kinases (JAK)), which are together responsible for the inflammatory response in rheumatoid arthritis. JAKs can transmit signals from various inflammatory messenger substances (interleukin-6 or interferons) into the cell. Therefore they are primarily responsible for triggering the destructive inflammation that occurs in rheumatoid arthritis. Inhibition of these enzymes can lead to suppression of painful immune response which results in this autoimmune disease. Tofacitinib, which has previously been on the market in the USA for some time now, was recently licensed in the European Union.