HEAD-TO-HEAD COMPARATIVE EFFICACY OF GOLIMUMAB VS. TOFACITINIB IN REACTIVE ARTHRITIS: A 52-WEEK REAL-WORLD COHORT STUDY FROM UZBEKISTAN

Abstract

Reactive arthritis (ReA) is an inflammatory joint disease triggered by urogenital or enteric infections. This 52-week prospective cohort from Uzbekistan compared the TNF-α inhibitor golimumab and the JAK inhibitor tofacitinib in 60 ReA patients. Both treatments produced significant reductions in DAREA, BASDAI, and inflammatory markers. Mean DAREA decreased from 4.7 to 1.6 with golimumab and from 4.5 to 1.1 with tofacitinib (p < 0.001). Cytokine levels (TNF-α, IL-17A) declined by over 40%, correlating with clinical improvement. Adverse events were mild, and no thromboembolic or fatal outcomes occurred. Tofacitinib achieved slightly faster and deeper responses, supporting its role as an effective oral alternative to biologic therapy in resource-limited settings.