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< 5
5-10
11-15
>15
1-5%
6-15%
16-25%
Any other
Hydroxychloroquine
Methotrexate
Sulfasalazine
Leflunomide
<10%
10-20%
21-30%
31-40%
Infliximab
Etanercept
Adalimumab
Tofacitinib
Early rheumatoid arthritis patients and csDMARD naive patients
Non-responder to csDMARDs
Intolerant to csDMARDs
Before switching from csDMARDs to biologicals
More than 3 years
More than 2 years
Less than a year
Rarely used
Moderately to severely active rheumatoid arthritis
Active ankylosing spondylitis
Active Psoriatic arthritis
All of the above
Superior Efficacy
Faster onset of action
Favourable safety profile
Oral route of administration
Tofacitinib IR 5 mg twice daily
Tofacitinib XR 11 mg once daily
Regular physical examinations
Laboratory tests- CBC, LFT, RFT, Lipid profile
TB Screening and Hepatitis B/ C Panel
Elderly patients
Younger individuals
Patient with co-morbid conditions
Very Effective
Moderately effective
Mildly effective
Preferred after failure of one csDMARDs
Preferred after failure of two csDMARDs
Preferred after failure of TNF inhibitor
Do not use
< 3 months
3- 6 months
6 – 12 months
>12 Months depending on tolerability
Can’t specify
Clinical remission
Improvement in disease activity scores
Radiographic findings
Yes
No
1-3 months
4-6 months
> 6 months
Comparable to biological DMARDs
Superior to biological DMARDs when combined with csDMARD
Less efficacious than biological DMARDs
Not observed
Most Cost-effective
Moderately cost-effective
Not cost-effective
Not sure
Affordability
Tolerability
Safety
Efficacy
Importance of adherence
Monitoring for side effects
Reporting any new symptoms promptly
Follow baseline & during the treatment lab investigations
Combining with csDMARDs
Combining with NSAIDs
Combining with Steroids
Continue as monotherapy
More Clinical trials and studies
Case study reports
Focus group meetings
Conference participation