Tofacitinib Versus Methotrexate as the First Line DMARD in the Treatment of Rheumatoid Arthritis

Tofacitinib Versus Methotrexate as the First Line DMARD in the Treatment of Rheumatoid Arthritis

It is a randomized controlled study

Randomization controlled study on Rheumatoid arthritis patients whos disease activity is high, controlled subjects will be given methotrexate and study subjects will get tofacitinib

Inclusion Criteria:1. age greater than 18 years 2. patients fulfill the ACR-EULAR classification criteria for RA 3.DAS-28 CRP more than 5.1

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Exclusion Criteria:

1. systemic infection
2. hemoglobin less than 9 mg/dl
3. WBC <4000, neutrophil <1000, platelet <100000/mm
4. live vaccine within 3 months
5. GFR < 50 ml/min
6. ALT > 2 times ULN
7. pregnancy