Tailoring Tofacitinib Oral Therapy in Rheumatoid Arthritis: The TuTOR App

Massimo Radin, Marta Arbrile, Irene Cecchi, Pierluigi Di Nunzio, Nicola Buccarano, Federico Di Gregorio, Valeria Milone, Sara Osella, Paola Crosasso, Marika Denise Favuzzi, Alice Barinotti, Simone Baldovino, Elisa Menegatti, Daniela Rossi, Savino Sciascia and Dario Roccatello
Additional contact information
Massimo Radin: Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, CMID-Nephrology and Dialysis, Department of Clinical and Biological Sciences, Ospedale San Giovanni Bosco, 10154 Turin, Italy
Marta Arbrile: Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, CMID-Nephrology and Dialysis, Department of Clinical and Biological Sciences, Ospedale San Giovanni Bosco, 10154 Turin, Italy
Irene Cecchi: Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, CMID-Nephrology and Dialysis, Department of Clinical and Biological Sciences, Ospedale San Giovanni Bosco, 10154 Turin, Italy
Pierluigi Di Nunzio: DNDG s.r.l., 10100 Turin, Italy
Nicola Buccarano: DNDG s.r.l., 10100 Turin, Italy
Federico Di Gregorio: DNDG s.r.l., 10100 Turin, Italy
Valeria Milone: Pharmacy Department, S. Giovanni Bosco Hospital, 10154 Turin, Italy
Sara Osella: Pharmacy Department, S. Giovanni Bosco Hospital, 10154 Turin, Italy
Paola Crosasso: Pharmacy Department, S. Giovanni Bosco Hospital, 10154 Turin, Italy
Marika Denise Favuzzi: Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, 20122 Turin, Italy
Alice Barinotti: Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, 20122 Turin, Italy
Simone Baldovino: Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, CMID-Nephrology and Dialysis, Department of Clinical and Biological Sciences, Ospedale San Giovanni Bosco, 10154 Turin, Italy
Elisa Menegatti: Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, 20122 Turin, Italy
Daniela Rossi: Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, CMID-Nephrology and Dialysis, Department of Clinical and Biological Sciences, Ospedale San Giovanni Bosco, 10154 Turin, Italy
Savino Sciascia: Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, CMID-Nephrology and Dialysis, Department of Clinical and Biological Sciences, Ospedale San Giovanni Bosco, 10154 Turin, Italy
Dario Roccatello: Center of Excellence for Nephrologic, Rheumatologic and Rare Diseases, CMID-Nephrology and Dialysis, Department of Clinical and Biological Sciences, Ospedale San Giovanni Bosco, 10154 Turin, Italy

IJERPH, 2022, vol. 19, issue 9, 1-11

Abstract: To support the management of rheumatoid arthritis (RA) patients treated with tofacitinib, we designed the TuTOR (tailoring tofacitinib oral therapy in rheumatoid arthritis) mobile app. The impact of the app on medical adherence was evaluated using a crossover design alternating a paper-diary and the TuTOR App. Twenty patients with RA (mean age at inclusion, 59 ± 13 years) were included in the study. A statistically significant decrease in DAS28 was observed since the first month of therapy (mean DAS28 at baseline, 3.9 ± 1 vs. 1° month 3.1 ± 1, p = 0.0016). Similarly, the numerical rating scale (NRS) of perceived activity of disease and subjective fatigue progressively decreased. No differences were reported in DAS28 or NRS between the TuTOR app and the paper-diary groups. A significant decrease was observed in HAQ during the follow-up (baseline 1.38 ± 1.11 vs. six months 0.83 ± 0.9; p = 0.01). When filling out the self-reporting questionnaires, most of the patients (82%) preferred the TuTOR App helping them to remember to take the pills. Furthermore, 82% of patients used the app regularly (vs. 53% for the paper diary). Three patients suspended tofacitinib due to gastrointestinal intolerance. Both digital and paper devices can help maximize adherence to therapy; however, the TuTOR app was preferred by the patients for its simplicity and immediacy.

Keywords: rheumatoid arthritis; adherence; mobile app; tofacitinib; digital health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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