Tofacitinib (a JAK inhibitor) is used when first-line treatments such as methotrexate, leflunomide, or sulfasalazine have not worked well or are not tolerated.
It helps reduce inflammation and prevent further joint damage in rheumatoid arthritis and psoriatic arthritis.
Tofacitinib blocks certain enzymes (Janus Kinases) inside immune cells that drive inflammation.
By switching off these signals, it reduces pain, swelling, and stiffness and helps protect joints.
Treatment usually begins with 5 mg once daily, then increased to 5 mg twice daily (BD) as tolerated.
Tablets can be taken with or without food.
Before starting tofacitinib, your doctor will arrange the following:
Some patients improve within a few weeks, but full benefits may take 2–3 months.
Continue taking the medicine as prescribed, even if you don’t feel better immediately.
If you have a high risk of heart disease, this medicine may not be suitable unless cleared by your cardiologist.
While taking tofacitinib, it is important to keep blood pressure, blood sugar, and cholesterol well controlled.
If your risks are high, your doctor may recommend an alternative treatment, most likely a TNF inhibitor. However, these medicines are much more expensive.
Regular blood tests are essential throughout treatment:
Without monitoring, you may develop side effects and the disease may remain uncontrolled, leading to ongoing joint damage.
Your rheumatologist will schedule tests and monitor your condition regularly.
Most patients tolerate tofacitinib well.
There is a rare risk of developing infections.
If you develop fever, cough, chest pain, or shortness of breath, stop the medicine and contact your doctor immediately.
Tofacitinib may be used alone or with methotrexate or other DMARDs.
Your doctor will decide the safest combination for you.
For more details, see the Australian Rheumatology Association (ARA) patient leaflet on Tofacitinib:
