Efficacy and Safety Evaluation of Tofacitinib in the Treatment of Elderly Patients with Inflammatory Knee Osteoarthritis

Objective : To evaluate the clinical efficacy and safety of tofacitinib in elderly patients with inflammatory knee osteoarthritis (KOA) who are unresponsive to or intolerant of non-steroidal anti-inflammatory drugs (NSAIDs), and to offer actionable evidence for clinical practice. Methods: Sixty-six patients (June 2023–June 2024) meeting the American College of Rheumatology (ACR) KOA diagnostic criteria were randomly assigned to two groups (n=33 each). The control group received oral meloxicam (7.5 mg once daily), while the treatment group received oral tofacitinib (5 mg twice daily). Both groups were co-administered glucosamine (0.75 g twice daily) for 12 months. Baseline characteristics were comparable between groups (P>0.05). Outcome measures included Visual Analog Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Karnofsky Performance Status (KPS) score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), knee joint ultrasound findings (suprapatellar effusion depth, synovial thickness), adverse events (AEs), and treatment completion rate. Results: The treatment group had superior improvements in VAS, WOMAC, KPS, ESR, CRP, and ultrasound indices (suprapatellar effusion, synovial thickness) versus the control group at 3, 6, and 12 months (P<0.05/P<0.01). Conclusion: Tofacitinib is safe and effective for elderly patients with inflammatory KOA who are unresponsive to or intolerant of NSAIDs. It significantly alleviates pain, improves joint function and quality of life, and delays joint degeneration.