A Consensus Report by the RAPID-India Group on Optimising Tofacitinib Treatment for Indian Patients with Rheumatoid Arthritis, Axial Spondyloarthritis and Psoriatic Arthritis

Rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) pose major global health challenges. These conditions are characterised by chronic widespread inflammation, leading to considerable morbidity and excess cardiovascular mortality. Despite advancements in therapy, very little in the form of consensus exists in India among musculoskeletal physicians and rheumatologists for the management of these conditions. The recommendations presented in this paper were developed by a steering committee, the RAPID-India, comprising academic rheumatologists who are key opinion leaders with diverse interests in rheumatology. With the help of the Delphi technique, they convened 3 advisory board meetings to discuss optimising to facitinib therapy for RA, axSpA and PsA. The paper particularly highlights aspects of pre-treatment screening, toxicity monitoring and specifics of use in the elderly. Additionally, long-term therapy with tofacitinib is advocated to prevent radiographic progression and maintain disease control; tapering strategies are also discussed. This consensus provides evidence-based recommendations to optimise disease outcomes by guiding healthcare professionals with special emphasis and focus only on tofacitinib use in inflammatory arthritis.