Baseline characteristics of PMR patients in tofacitinib and glucocorticoid group.
shoulder girdle, morning stiffness
DISEASE, PMR, REMISSION, POLYMYALGIA RHEUMATICA
CRP, c-reactive protein; ESR, erythrocyte sedimentation rate; EUL, ability to elevate the upper limbs (0 = lifted above the shoulder girdle, 1 = to the shoulder girdle, 2 = below the shoulder girdle, 3 = cannot lift); NSAID, nonsteroidal anti-inflammatory drug; PMR, polymyalgia rheumatica; PMR-AS, PMR activity disease score; SD, standard deviation; VS, visual analogue scale.PMR-AS: CRP (mg/dl) + patient self-evaluation (0–10 visual scale) + physician global assessment (0–10 visual scale) + [morning stiffness (min) × 0.1] + EUL (0–3).Furthermore, the blood samples were collected from 4 patients under treatment with tofacitinib at week 24, and it was isolated from 1 patient at week 12. The gene expression profiles of patients with PMR that were in remission after tofacitinib therapy (the PMR-R group) differed from those of patients in the newly diagnosed PMR with active disease activity (PMR) group (PMR-R versus PMR; 1,403 DEGs shown in In the tofacitinib group, 2 patients personally reduced the dose of tofacitinib from 5 mg BID to 5 mg QD at week 20 and then kept the dosage until week 24. Another patient reduced the dose of tofacitinib from 5 mg BID to 5 mg QD at week 8 and then kept the dosage until week 24. All 3 patients were always in remission even after reducing the dose of tofacitinib.One patient in the tofacitinib group had a rapid decrease in PMR-AS score (28.72 to 2.85) at the initial 4 weeks, but had an increase in PMR-AS score (7.77) at week 12, finally reduced to lower disease activity at week 24. One patient in the glucocorticoid group had a good response well (24.87 to 2.2) at the initial 16 weeks, but had disease exacerbation (2.2 to 7.6) at week 20, eventually a disease score of 4.97 at week 24. There were 4 patients lost to the follow-up due to traffic inconvenience but still had a good response to tofacitinib (PMR-AS score < 10) at weeks 8 to 12. In the control group, 5 cases had a good response to glucocorticoid (PMR-AS score < 10) at weeks 8 to 16 but were lost to the follow-up after week 16.