Tofacitinib versus BAFF inhibitor in mild to moderate systemic lupus erythematosus: a real-world study based on CSTAR...

Compare the efficacy of tofacitinib and BAFF inhibitor (belimumab and telitacicept) in mild to moderate systemic lupus erythematosus patients.

Overall, 33 patients treated with tofacitinib and 34 patients treated with BAFF inhibitor (23 patients underwent belimumab and 11 patients underwent telitacicept) were enrolled in this study. The patients were evaluated at 1, 3, 6, and 12 months after the baseline. The primary endpoint was set as the proportion of patients who achieved British Isles Lupus Assessment Group-based Composite Lupus Assessment (BICLA) response.

At 3 months, BICLA responses were achieved in 27 (81.8%) patients treated with tofacitinib and 18 (52.9%) individuals treated with BAFF inhibitor. The BICLA response rate of tofacitinib is significantly higher than that of BAFF inhibitor (p = 0.012). Meanwhile, there was no discernible difference between the patients in the tofacitinib-treated group and the BAFF inhibitor-treated group in terms of the 3-month arthritis resolution rate (p = 0.117) or the mucocutaneous resolution rate (p = 0.175). Only one patient reported adverse events in the TOFA group during the 1-year follow-up. No severe adverse events, including infections, thromboembolic events, or deaths, were reported in both groups.

Compared to BAFF inhibitors, tofacitinib showed the potential efficacy in individuals with mild to moderate SLE. The results paved the way to optimal utilization of tofacitinib in SLE patients. Key Points • BAFF inhibitor is recommended as first-/second-line therapy for mild to moderate SLE patients. • The rapid efficacy of tofacitinib in treating mucocutaneous involvement and arthritis in lupus has been demonstrated. • This study firstly compares tofacitinib with BAFF inhibitor in SLE patients, suggesting that tofacitinib can faster achieve promising therapeutic effects in mild to moderate SLE patients.