A hierarchical cluster analysis for clinical profiling of tofacitinib treatment response in patients with rheumatoid arthritis.

Autor: Janahiraman S; School of Postgraduate Studies, IMU University, Kuala Lumpur, Malaysia. drsivakamiphd@gmail.com.; Department of Pharmacy, Hospital Selayang, Ministry of Health Malaysia, Selangor Darul Ehsan, Malaysia. drsivakamiphd@gmail.com., Shahril NS; Rheumatology Unit, Department of Medicine, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia., Jayaraj VJ; Sector for Biostatistics & Data Repository, National Institutes of Health Complex, Ministry of Health Malaysia, Selangor Darul Ehsan, Malaysia., Ch'ng S; Rheumatology Unit, Department of Medicine, Hospital Selayang, Ministry of Health Malaysia, Selangor Darul Ehsan, Malaysia., Eow LH; Rheumatology Unit, Department of Medicine, Hospital Tuanku Ja'afar Seremban, Ministry of Health Malaysia, Negeri Sembilan, Malaysia., Mageswaren E; Rheumatology Unit, Department of Medicine, Hospital Tengku Ampuan Rahimah, Ministry of Health Malaysia, Selangor Darul Ehsan, Malaysia., Lim AL; Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Ministry of Health Malaysia, Pulau Pinang, Malaysia., Chong HC; Rheumatology Unit, Department of Medicine, Hospital Melaka, Ministry of Health Malaysia, Melaka, Malaysia., Ong PS; Rheumatology Unit, Department of Medicine, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Perak Darul Ridzuan, Malaysia., Ismail AM; Rheumatology Unit, Department of Medicine, Hospital Raja Perempuan Zainab II, Ministry of Health Malaysia, Kelantan Darul Naim, Malaysia., Rahim SMA; Rheumatology Unit, Department of Medicine, Hospital Sultanah Nur Zahirah, Ministry of Health Malaysia, Terengganu Darul Iman, Malaysia., Ng CR; Rheumatology Unit, Department of Medicine, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Darul Ta'zim, Malaysia., Suahilai DM; Rheumatology Unit, Department of Medicine, Hospital Tengku Ampuan Afzan, Ministry of Health Malaysia, Pahang Darul Makmur, Malaysia., Ramlan AH; Rheumatology Unit, Department of Medicine, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Kedah Darul Aman, Malaysia., Too CL; Immunogenetic Unit, Institute for Medical Research, National Institutes of Health Complex, Ministry of Health Malaysia, Selangor Darul Ehsan, Malaysia., Leong CO; Centre for Cancer and Stem Cell Research Development and Innovation (IRDI), Institute for Research, IMU University, Kuala Lumpur, Malaysia.; AGTC Genomics, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Clinical rheumatology [Clin Rheumatol] 2024 Aug; Vol. 43 (8), pp. 2489-2501. Date of Electronic Publication: 2024 Jun 26.
DOI: 10.1007/s10067-024-07035-x
Abstrakt: Tofacitinib is the first oral JAK inhibitor approved for treating rheumatoid arthritis (RA). To enhance our understanding of tofacitinib drug response, we used hierarchical clustering to analyse the profiles of patient who responded to the treatment in a real-world setting. Patients who commenced on tofacitinib treatment were selected from 12 major rheumatology centres in Malaysia. The aim was to assess their response to tofacitinib defined as achieving DAS28-CRP/ESR ≤ 3.2 and DAS28 improvement > 1.2 at 12 weeks. A hierarchical clustering analysis was performed using sociodemographic and clinical parameters at baseline. All 163 RA patients were divided into three clusters (Clusters 1, 2 and 3) based on specific clinical factors at baseline including bone erosion, antibody positivity, disease activity and anaemia status. Cluster 1 consisted of RA patients without bone erosion, antibody negative, low baseline disease activity measure and absence of anaemia. Cluster 2 comprised of patients without bone erosion, RF positivity, anti-CCP negativity, moderate to high baseline disease activity score and absence of anaemia. Cluster 3 patients had bone erosion, antibody positivity, high baseline disease activity and anaemia. The response rates to tofacitinib varied among the clusters: Cluster 1 had a 79% response rate, Cluster 2 had a 66% response rate, and Cluster 3 had a 36% response rate. The differences in response rates between the three clusters were found to be statistically significant. This cluster analysis study indicates that patients who are seronegative and have low disease activity, absence of bone erosion and no signs of anaemia may have a higher likelihood of benefiting from tofacitinib therapy. By identifying clinical profiles that respond to tofacitinib treatment, we can improve treatment stratification yielding significant benefits and better health outcomes for individuals with RA.
(© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)
Databáze: MEDLINE
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