Changes of Depression After First-year of Tofacitinib in RA Patients

The CUDOS questionnaire assessed the level of depression in the past week. It consisted of 18 questions. For each question the participant indicated how well it described his/her feelings during past week on the following scale: 0 = not at all true, 1 = rarely true, 2 = sometimes true, 3 = often true and 4 = almost always true. The result of this questionnaire was the sum of responses to all questions and therefore the overall possible CUDOS score ranged from 0 to 72, higher score indicated more severe depression. Absolute values of CUDOS score at baseline (Visit 1) and 12 Months (Visit 3) are reported in descriptive data below. Mean relative change was calculated by averaging the relative changes of each of the participants (sum of all relative changes divided by the number of participants) and was reported in the statistical section.

The CUDOS questionnaire assessed the level of depression in the past week. It consisted of 18 questions. For each question the participant indicated how well it described his/her feelings during past week on the following scale: 0 = not at all true, 1 = rarely true, 2 = sometimes true, 3 = often true and 4 = almost always true. The result of this questionnaire was the sum of responses to all questions and therefore the overall possible CUDOS score ranged from 0 to 72, higher score indicated more severe depression. Absolute values of CUDOS score at baseline (Visit 1) and 6 Months (Visit 2) are reported in descriptive data below. Mean relative change was calculated by averaging the relative changes of each of the participants (sum of all relative changes divided by the number of participants) and was reported in the statistical section.

The clinically useful anxiety outcome scale (CUXOS) questionnaire assessed the level of anxiety in the past week. It consisted of 20 questions. For each question the participant indicated how well it described his/her feelings during past week on the following scale: 0 = not at all true, 1 = rarely true, 2 = sometimes true, 3 = often true and 4 = almost always true. The result of this questionnaire was the sum of responses to all questions and therefore the overall possible CUXOS score ranged from 0 to 80, higher score indicated higher anxiety level. Absolute values of CUXOS score at baseline (Visit 1), 6 Months (Visit 2) and 12 Months (Visit 3) are reported in descriptive data below. Mean relative change was calculated by averaging the relative changes of each of the participants (sum of all relative changes divided by the number of participants) and was reported in the statistical section.

The Jenkins sleep evaluation questionnaire (JSEQ) questionnaire assessed the level of insomnia, sleep disturbance in the past month. It consisted of 4 questions related to 1) trouble falling asleep, 2) trouble staying asleep, 3) waking up several times per night, and 4) waking up feeling tired and worn out after a usual amount of sleep. The response alternatives were: 0 = not at all, 1 = 1-3 days, 2 = 4-7 days, 3 = 8-14 days, 4 = 15-21 days, and 5 = 22-30 days. The result of this questionnaire was the sum of responses to all questions and therefore the overall possible JSEQ score ranged from 0 to 20, higher score indicated lower sleep quality. Absolute values of JSEQ score at baseline (Visit 1), 6 Months (Visit 2) and 12 Months (Visit 3) are reported in descriptive data below. Mean relative change was calculated by averaging the relative changes of each of the participants (sum of all relative changes divided by the number of participants) and was reported in the statistical section.

Participants assessed how much arthritis impacted their life using a 100 millimeter (mm) visual analogue score (VAS) by placing a mark on the scale between 0 (not affecting) and 100 (maximal impact), which corresponded to the level arthritis affected their life. The score ranged from 0 mm to 100 mm, higher score indicated higher impact of arthritis on participants life. Absolute values of VAS score at baseline (Visit 1), 6 Months (Visit 2) and 12 Months (Visit 3) are reported in descriptive data below. Mean relative change was calculated by averaging the relative changes of each of the participants (sum of all relative changes divided by the number of participants) and was reported in the statistical section.

Number of participants who took at least 1 concomitant treatment like antidepressants, anxiolytics and hypnotics were reported in this outcome measure. Participants could have been counted in more than one category.

Number of participants with change in number of used medications and in their dosage between 12 Months (Visit 3) and Baseline (Visit 1) were reported in this outcome measure.

Disease activity score 28-4 (DAS28-4) C-reactive protein (CRP) was calculated from 28-tender joint counts and 28-swollen joint counts, CRP (milligram per liter [mg/L]) and patient global assessment (PGA); participant assessed overall disease activity on VAS, score: 0 [no arthritis] to 100 [extreme arthritis]. DAS 28 -4 CRP = 0.56*sqrt (TJC28) + 0.28*sqrt (SJC28) + 0.36*In (CRP in mg/1 + 1) + 0.014*PtGA + 0.96; ln = natural logarithm, sqrt = square root of, mg = milligram, PtGA = patient's global assessment of health. DAS28-4 (CRP) lower than (<) 2.6 = RA in remission, 2.6 to 3.2 = low level of disease activity, 3.2 to 5.1 = active disease, may require change of treatment and greater than (>) 5.1 = very active disease, required careful monitoring and change of treatment. Total score range: 0 to 9.4, higher score indicated more disease activity.

Remission was defined as DAS28-4 (CRP) < 2.6. DAS28-4 CRP was calculated from 28-tender joint counts and 28-swollen joint counts, CRP (mg/L) and PGA; participant assessed overall disease activity on VAS, score: 0 [no arthritis] to 100 [extreme arthritis]. DAS 28 -4 CRP = 0.56*sqrt (TJC28) + 0.28*sqrt (SJC28) + 0.36*In (CRP in mg/1 + 1) + 0.014*PtGA + 0.96; ln = natural logarithm, sqrt = square root of, mg = milligram, PtGA = patient's global assessment of health. DAS28-4 (CRP) < 2.6 = RA in remission, 2.6 to 3.2 = low level of disease activity, 3.2 to 5.1 = active disease, may require change of treatment and > 5.1 = very active disease, required careful monitoring and change of treatment. Total score range: 0 to 9.4, higher score indicated more disease activity.

Low disease activity (LDA) was defined as DAS28-4 (CRP) < 3.2. DAS28-4 CRP was calculated from 28-tender joint counts and 28-swollen joint counts, CRP (mg/L) and PGA; participant assessed overall disease activity on VAS, score: 0 [no arthritis] to 100 [extreme arthritis]. DAS 28 -4 CRP = 0.56*sqrt (TJC28) + 0.28*sqrt (SJC28) + 0.36*In (CRP in mg/1 + 1) + 0.014*PtGA + 0.96; ln = natural logarithm, sqrt = square root of, mg = milligram, PtGA = patient's global assessment of health. DAS28-4 (CRP) < 2.6 = RA in remission, 2.6 to 3.2 = low level of disease activity, 3.2 to 5.1 = active disease, may require change of treatment and > 5.1 = very active disease, required careful monitoring and change of treatment. Total score range: 0 to 9.4, higher score indicated more disease activity.

EQ-5D-3L designed to assess impact on health-related quality of life in 5 domains: mobility, self-care, usual activities, pain/discomfort, anxiety/depression. Each domain had 3 responses and scored from 1-3 (1=no problems; 2=some problems; 3=extreme problems). The mean of the summed score ranged from 1 to 3 with "1" corresponding to no problems and "3" corresponding to severe problems, where higher score indicated more severe problems. The EQ-5D-3L index score summarized each possible health state on a numerical scale ranging from -0.594 to 1. A score of 1 indicated full health, score of 0 indicated a state equivalent to being dead, and score lower than 0 indicated a state equivalent to the worst possible health status. Higher score indicated a better quality of life.

An AE was any untoward medical occurrence in a participant who received study intervention without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs included both SAEs and all non-SAEs. TEAEs were defined as newly occurring (not present at baseline) or worsening after first dose of study treatment.