Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: Assessment of Tofacitinib Usage in the Management of Rheumatoid Arthritis in India (ASSET Survey)

The advent of tofacitinib has revolutionized the treatment of several immune-mediated inflammatory diseases (IMIDs), especially the more refractory cases. JAK-STAT pathway regulates many pro-inflammatory cytokines which mediate the inflammation in rheumatoid arthritis.

JAK inhibitors act intracellularly to block this pathway and thereby inhibit multiple cytokines at atime. These are the small molecules which offer several advantages over biological disease modifying anti-rheumatic drugs.

Tofacitinib is the first JAK inhibitor which has been approved globally and in India for the treatment of rheumatoid arthritis, psoriatic arthritis and ulcerative colitis. It is available in two formulations; 5 mg immediate release (IR) and 11 mg extended release (XR). It is available in oral tablet form. It does not cause immunogenicity there does not lead to development of anti-drug antibodies. It does not require cold chain for storage.

Tofacitinib has the potential to re-instate disease control and offer the possibility of even controlling extra-articular manifestations of rheumatoid arthritis which is bad prognostic factor of the primary affliction. The value of Tofacitinib as an effective option to switch from other biologics is becoming more and more prominent. This is also evidenced by the high persistence to Tofacitinib by such patients

There is limited data available on the usage and place of tofacitinib in the RA management in India. Therefore, this cross-sectional study is designed to understand the management of RA and role of tofacitinib in RA management in India.

If you agree to participate, you will be required to respond to questions of the enclosed questionnaire. We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.