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NCT01932372

Tofacitinib (Xeljanz) Special Investigation for Rheumatoid Arthritis

Completed Results posted Last updated 26 October 2024
What this trial tests

trial testing Tofacitinib (Xeljanz) in Rheumatoid Arthritis in 9,968 participants. Completed in 24 August 2021.

Timeline
26 July 2013
Primary endpoint
24 August 2021
24 August 2021

Quick facts

Lead sponsorPfizer
StatusCompleted
Study typeOBSERVATIONAL
Enrollment9,968
Start date26 July 2013
Primary completion24 August 2021
Estimated completion24 August 2021
Sites1 location across Japan

Drugs / interventions tested

Conditions studied

Sponsor

Pfizer — full company profile →

Who can join

0 and older, any sex, with Rheumatoid Arthritis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Participants With Treatment-related Adverse Events or Serious Treatment-related Adverse Events in Participants Who Received XELJANZ Primary · 36 months

An adverse drug reaction (ADR) was any untoward medical occurrence attributed to XELJANZ in a participant who received XELJANZ. A serious adverse event/adverse drug reaction (SADR) was a treatment-related adverse event resulting in any of the following outcomes or deemed significant for any other reason: death; life-threatening experience (immediate risk of dying); initial or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly. Relatedness to XELJANZ was assessed by the physician.

ADR
GroupValue95% CI
XELJANZ (MTX Adherent Safety Analysis Set)41.60
Serious ADR
GroupValue95% CI
XELJANZ (MTX Adherent Safety Analysis Set)12.88
Occurrence of Serious Infection Events Secondary · 12 months

Comparison of time to serious infection between XELJANZ group and control group. Hazard ratio (unadjusted): Baseline characteristics are unadjusted Hazard ratio (adjusted 1): Adjusted by propensity score estimated by logistic regression Hazard ratio (adjusted 2): Adjusted by propensity score estimated by random forest Hazard ratio (adjusted 3): Adjusted by propensity score estimated by logistic regression (with upper limit of weighting) Hazard ratio (adjusted 4): Adjusted by propensity score estimated by random forest (with upper limit of weighting)

GroupValue95% CI
XELJANZ (MTX Adherent Comparative Safety Analysis Set)6.865.96 – 7.86
Control (MTX Adherent Comparative Safety Analysis Set)1.420.97 – 2.00
Occurrence of Malignancy Secondary · 36 months

Comparison of time to malignancy between XELJANZ group and control group. The standard incidence ratio (SIR) was calculated using the general Japanese population as the reference population. Hazard ratio (unadjusted): Baseline characteristics are unadjusted Hazard ratio (adjusted 1): Adjusted by propensity score estimated by logistic regression Hazard ratio (adjusted 2): Adjusted by propensity score estimated by random forest Hazard ratio (adjusted 3): Adjusted by propensity score estimated by logistic regression (with upper limit of weighting) Hazard ratio (adjusted 4): Adjusted by propensit

Incidence rate
GroupValue95% CI
XELJANZ (MTX Adherent Comparative Safety Analysis Set)1.401.18 – 1.66
Control (MTX Adherent Comparative Safety Analysis Set)0.880.66 – 1.15
SIR
GroupValue95% CI
XELJANZ (MTX Adherent Comparative Safety Analysis Set)1.381.16 – 1.62
Control (MTX Adherent Comparative Safety Analysis Set)0.980.73 – 1.28
Occurrence of Death Secondary · 36 months

Comparison of time to death between XELJANZ group and control group. The standardized mortality ratio (SMR) was calculated using the general Japanese population as the reference population. Hazard ratio (unadjusted): Baseline characteristics are unadjusted

Mortality rate
GroupValue95% CI
XELJANZ (MTX Adherent Comparative Safety Analysis Set)0.890.72 – 1.10
Control (MTX Adherent Comparative Safety Analysis Set)0.260.15 – 0.43
SMR
GroupValue95% CI
XELJANZ (MTX Adherent Comparative Safety Analysis Set)1.020.82 – 1.26
Control (MTX Adherent Comparative Safety Analysis Set)0.390.23 – 0.64
Change in Disease Activity Based on Simplified Disease Activity Index (SDAI) Primary · Baseline, 1, 6, 12, 24, 36 months

The SDAI is the numerical sum of five outcome parameters: tender joint count (TJC) and swollen joint count (SJC) based on a 28-joint assessment, patient global assessment (PtGA) and physician global assessment (PGA) assessed on 0-10 cm VAS, and C-reactive protein (CRP) (mg/dL). SDAI is defined as follows: ≤3.3, disease remission; \>3.3 to ≤11, low disease activity, \>11 to ≤26, moderate disease activity; and \>26, high disease activity. SDAI was assessed at each evaluation time point and mean change from the start of XELJANZ was calculated with the 95% CI.

GroupValue95% CI
XELJANZ (MTX Adherent Efficacy Analysis Set) At 1 Month From Baseline-10.16-10.69 – -9.62
XELJANZ (MTX Adherent Efficacy Analysis Set) At 6 Months From Baseline-14.59-15.10 – -14.07
XELJANZ (MTX Adherent Efficacy Analysis Set) At 12 Months From Baseline-15.97-16.62 – -15.32
XELJANZ (MTX Adherent Efficacy Analysis Set) At 24 Months From Baseline-16.88-17.64 – -16.12
XELJANZ (MTX Adherent Efficacy Analysis Set) At 36 Months From Baseline-17.37-18.21 – -16.53
Change in Disease Activity Score Based on 28-joints Count (DAS28) Primary · Baseline, 1, 6, 12, 24, 36 months

DAS28 is the numerical sum of 4 outcome parameters: tender joint count (TJC) and swollen joint count (SJC) based on a 28-joint assessment, PtGA assessed on 0-10 cm VAS, and the erythrocyte sedimentation rate (ESR) (millimeters per hour \[mm/hour\]). DAS28 is defined as follows: \<2.6, disease remission; ≥2.6 to \<3.2, low disease activity, ≥3.2 to ≤5.1, moderate disease activity; and \>5.1, high disease activity. DAS28 was assessed at each evaluation time point and mean change from the start of XELJANZ was calculated with the 95% CI.

GroupValue95% CI
XELJANZ (MTX Adherent Efficacy Analysis Set) At 1 Month From Baseline-0.98-1.04 – -0.92
XELJANZ (MTX Adherent Efficacy Analysis Set) At 6 Months From Baseline-1.52-1.58 – -1.46
XELJANZ (MTX Adherent Efficacy Analysis Set) At 12 Months From Baseline-1.67-1.75 – -1.59
XELJANZ (MTX Adherent Efficacy Analysis Set) At 24 Months From Baseline-1.82-1.91 – -1.73
XELJANZ (MTX Adherent Efficacy Analysis Set) At 36 Months From Baseline-1.86-1.96 – -1.76

Adverse events — posted to ClinicalTrials.gov

Time frame: 36 months. Reporting threshold: 2%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

XELJANZ (Safety Analysis Set)
Serious: 1351/7021 (19%)
Deaths: 188/7021
XELJANZ (MTX Adherent Comparative Safety Analysis Set)
Serious: 773/3731 (21%)
Deaths: 98/3731
Control (MTX Adherent Comparative Safety Analysis Set)
Serious: 112/2419 (5%)
Deaths: 16/2419

Serious adverse events (602 terms)

ReactionSystemXELJANZ (Safety Analysis S…XELJANZ (MTX Adherent Comp…Control (MTX Adherent Comp…
PneumoniaInfections and infestations
Herpes zosterInfections and infestations
Interstitial lung diseaseRespiratory, thoracic and mediastinal disorders
FallInjury, poisoning and procedural complications
Rheumatoid arthritisMusculoskeletal and connective tissue disorders
Pneumonia bacterialInfections and infestations
Spinal compression fractureInjury, poisoning and procedural complications
CellulitisInfections and infestations
Pneumocystis jirovecii pneumoniaInfections and infestations
Femoral neck fractureInjury, poisoning and procedural complications
Urinary tract infectionInfections and infestations
Colon cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
SepsisInfections and infestations
Gastric cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
PyelonephritisInfections and infestations
Femur fractureInjury, poisoning and procedural complications
Lung neoplasm malignantNeoplasms benign, malignant and unspecified (incl cysts and polyps)
AnaemiaBlood and lymphatic system disorders
PyrexiaGeneral disorders
BronchitisInfections and infestations
Tendon ruptureInjury, poisoning and procedural complications
DeathGeneral disorders
OsteoarthritisMusculoskeletal and connective tissue disorders
Lymphocyte count decreasedInvestigations
Breast cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Other adverse events (6 terms — click to expand)

ReactionSystemXELJANZ (Safety Analysis S…XELJANZ (MTX Adherent Comp…Control (MTX Adherent Comp…
Herpes zosterInfections and infestations
Hepatic function abnormalHepatobiliary disorders
Upper respiratory tract inflammationRespiratory, thoracic and mediastinal disorders
NasopharyngitisInfections and infestations
Lymphocyte count decreasedInvestigations
BronchitisInfections and infestations

Most-reported serious reactions: Pneumonia, Herpes zoster, Interstitial lung disease, Fall, Rheumatoid arthritis, Pneumonia bacterial, Spinal compression fracture, Cellulitis.

Data from ClinicalTrials.gov NCT01932372 adverse events section.

Sponsor's own description

The objective of this Surveillance is to verify the following subject matters concerning Tofacitinib (Xeljanz) under general practice. 1\) Occurrence of adverse reactions, factors that may potentially affect safety and efficacy 2) Long-term safety (particularly, malignant tumors and serious infections) and efficacy Occurrences of malignant tumors and serious infections will be compared with a control group.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Six-month safety and effectiveness of tofacitinib in patients with rheumatoid arthritis in Japan: Interim analysis of post-marketing surveillance.
    Kuwana M, Sugiyama N, Momohara S, Atsumi T, et al · · 2024 · cited 9× · PMID 37405710 · DOI 10.1093/mr/road063
  2. Risk Factors for Major Adverse Cardiovascular Events, Malignancies, and Serious Infections With Tofacitinib in Rheumatoid Arthritis: Post Hoc Analysis of a 3-Year J-Post-Marketing Surveillance.
    Yamaoka K, Hoshi M, Endo Y, Hirano T. · · 2026 · cited 1× · PMID 41663902 · DOI 10.1111/1756-185x.70572
  3. Safety signal detection and evaluation in clinical development programs: A case study of tofacitinib.
    Dasic G, Jones T, Frajzyngier V, Rojo R, et al · · 2018 · cited 1× · PMID 29417755 · DOI 10.1002/prp2.371

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