Tofacitinib generics offer a practical solution for patients with axial spondyloarthritis (axSpA) by reducing the need for conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and non-steroidal anti-inflammatory drugs (NSAIDs), outlined a study issued in October 2023 in 'Cureus'. axSpA presents a challenging landscape for treatment. Tofacitinib, initially validated through clinical trials, has emerged as a viable therapeutic option for axSpA.

However, the real-world efficacy of Tofacitinib generics in managing axSpA, especially in India where csDMARDs are widely used, remains a subject of limited exploration. This study aimed to investigate the possibility of Tofacitinib generics in reducing the reliance on csDMARDs and NSAIDs in the axSpA population. Conducted retrospectively in a real-world clinical setting, the study involved the analysis of data from 9 rheumatology centres across India.

A total of 168 active axSpA patients were included, who were prescribed generic Tofacitinib dosed 5 mg given two times every day, along with csDMARDs and NSAIDs over 6 months.

The primary objective was to assess the ability of Tofacitinib generics to spare the use of csDMARDs and NSAIDs, with the secondary goal of assessing its safety and efficacy after 6 months. The median Ankylosing Spondylitis Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR) score of the patients under consideration was 3.91.

Among the patients receiving Tofacitinib generics, 72% were concurrently administered csDMARDs (Methotrexate/Sulfasalazine/both), and 53.6% were also receiving NSAIDs. Impressively, Tofacitinib generics exhibited substantial sparing effects, as shown in Table 1:

Notably, mild and well-tolerated adverse events were reported. About 57.9% of patients had achieved clinically significant improvements in their ASDAS ESR scores, with a median decrease of 2.02 after 6 months. This study unveils a novel dimension in the management of axSpA with Tofacitinib generics.