Objective: To assess the real-life efficacy, retention rate and safety data of tofacitinib in rheumatoid arthritis (RA) patients. Method: We analyzed all patients registered in the HURBİO database who received at least 1 dose of tofacitinib. Patients who received at least one dose included in retention analysis, with at least 1 control visit, were included in efficacy and safety analysis. Factors predicting good response at last follow-up visit were analyzed by the logistic regression analysis. Drug retention rates were calculated using the Kaplan-Meier method and predictors of drug retention was determined by Cox proportional hazard model. Adverse events, reasons of switching and discontinuation were also determined. Results: 247 (210, 85.0% female) patients included in the study. Median duration of tofacitinib treatment was 10.2 (20.2) (med, (IQR)) months. 204 (82.6%) patients included in safety and efficacy analysis. 45.6% of patients was in low-disease activity (LDA) state (DAS28-CRP≤3.2). Predictors of LDA were being biologic-navie (aOR 2.53 (1.31-4.88); 95% CI) and RF negativity (aOR 2.14 (1.12-4.07); 95% CI). At 1 year, overall tofacitinib retention rate was 63.9% with no relevant predicting factor. Response and retention rates of tofacitinib were similar in patients with and without concomitant csDMARDs. Treatment failure was the most common cause of discontinuation. The most common infectious and laboratory adverse events were herpes zoster infection (3.9 per 100 patient-years) and elevation in ALT (x3UNL: 9.7 per 100 patient-years), respectively. Conclusion: In conclusion, tofacitinib is an effective-as monotherapy or combination with csDMARDs-and well-tolerated treatment option in Turkish RA patients.

The current COVID-19 pandemic raises several clinical challenges. Cases of COVID-19-associated arthritis have been reported, and inconsistently described as either COVID-19 viral arthritis or COVID-19 reactive arthritis. We aimed to review all the reported cases of ‘COVID-19-associated arthritis’, which we propose, is a better term to define the entire spectrum of new-onset arthritis believed to be associated with SARS-CoV-2 infection. We performed a systematic literature review using MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews to search for articles published up to 13 December 2021. We included cohort studies, case series and case reports describing patients diagnosed with COVID-19 reactive or viral arthritis by a physician, irrespective of fulfilment of classification criteria. To identify relevant studies, medical subject headings and keywords related to ‘COVID-19/SARS-CoV-2 infection’ and ‘reactive arthritis’ were used. Our search retrieved 419 articles, of which 31 were included in the review. A total of 33 cases were reported in these 31 articles, the majority being adults (28/33=85%) with peripheral joint involvement (26/33=79%). Most of the patients responded well to treatment and the disease was self-limiting. These 33 case reports describe a possible causal relationship between exposure to SARS-CoV-2 and the onset of arthritis. However, since these cases were reported during a pandemic, other aetiologies cannot be fully excluded. The exact mechanism through which SARS-CoV-2 might trigger arthritis is not fully understood and robust epidemiological data to support a causal relationship are still lacking.

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Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

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