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[Comment] Treating active rheumatoid arthritis with Janus kinase inhibitors

The ORAL Strategy trial1 by Roy Fleischmann and colleagues in The Lancet studied patients with active rheumatoid arthritis. They had all responded inadequately to methotrexate, the dominant conventional disease-modifying antirheumatic drug (DMARD). The key comparison in the trial was the effects of a combination of different treatments with methotrexate. One treatment was tofacitinib. This drug is an orally active Janus kinase (JAK) inhibitor, a relatively new type of drug for rheumatoid arthritis.