0291: Tofacitinib Leads to Significant Weight Gain - A Real Life Experience of 429 Patients

Naga Prabu¹, velammal petchaippan², Gayathri anand³, Aswathi kumar¹ and Saranya Ramachandiran³, ¹SAKTHI RHEUMATOLOGY CENTRE PVT LTD, Coimbatore, India, ²PSG INSTTUTE OF MEDICAL SCIENCES AND RESEARCH, Coimbatore, India, ³sakthi rheumatology centre pvt l;td, Coimbatore, India

Background/Purpose: Tofacitinib(Tofa) an oral Janus kinase inhibitor(JAK) has shown good promise in the management of rheumatoid arthritis and psoriatic arthritis. While being increasingly used in the management of rheumatoid arthritis in view of the ease of administration and reduction of cost after the patent period, it's being more commonly used /misused by both rheumatologist and non rheumatologist. While the known adverse events of infections (herpes zoster flare up) and cardiovascular events are evident after the clinical trial results, there was an observational study which mentioned weight gain as a prominent adverse event after tofacitinib therapy

Methods: We retrieved patients records who were prescribed tofacitinib for various indications (rheumatoid arthritis , psoriatic arthritis,spondyloarthritis ) from January 2020 to December 2021.Demographics,comorbid illness,body weight (kilograms),mean duration of tofa intake, concomitant drugs, adverse events and lab investigations were taken for analysis. Patients with no follow-up records, no weight recordings and with less than 6 months follow-up were excluded.

Results: There were a total of 693 patients out of which 429 patients fulfilled the inclusion criteria.There were 377 RA patients and 52 with spondyloarthritis.Of the 429 patients, 292(68%) had weight gain,107(25%) had weight loss and 30(7%) had no change in weight.In RA subgroup 255(68%) had weight gain; 94(25%) had weight loss and 28(7%) had no change in weight. In spondyloarthritis subgroup 37(71%) had weight gain;13((25%) had weight loss and 2(4%)had no change in weight .There was a significant gain in weight of 1.65(0.47)kg in the entire cohort. Spondyloarthritis group had relatively more gain in weight(kg) 2.57(1.11) than RA patients 1.52(0.52)

Conclusion: Tofacitinib leads to significant weight gain in 68% of study patients which is more with Spondyloarthritis than Rheumatoid arthritis. Physician's prescribing tofacitinib should take this into consideration.

Disclosures: N. Prabu, None; v. petchaippan, None; G. anand, None; A. kumar, None; S. Ramachandiran, None.