Is it necessary to take tofacitinib/Shangjie for a long time to treat rheumatoid arthritis?

Tofacitinib/Shangjie(Tofacitinib), as an oral JAK inhibitor, has been widely used internationally for the mid- and long-term control treatment of rheumatoid arthritis (RA). For many patients, the most common question is: Does tofacitinib have to be taken long-term? The answer often depends on the characteristics of the disease itself and the patient's pattern of response to the medication. Judging from global clinical practice experience, rheumatoid arthritis is a persistent, autoimmune-mediated chronic disease. The treatment goal is not only to relieve pain, but more importantly, to control inflammation in the long term and prevent the destruction of joint structures. Therefore, as a control drug, tofacitinib often requires long-term maintenance use.

Rheumatoid arthritis is a relapsing disease. Once medication is stopped, the immune system may be triggered again, leading to increased inflammation, joint pain, swelling, and functional impairment. Tofacitinib reduces the abnormal signaling of cytokines in the body by inhibiting the JAK pathway, thereby achieving continuous regulation of the immune system. However, this effect is not a one-time or short-term fix, but requires maintaining a stable drug concentration to continue to work. Therefore, many overseas guidelines emphasize that tofacitinib should be used as a long-term management tool rather than a short-term analgesic.

Of course, long-term use does not mean “a fixed dose remains unchanged indefinitely”. After the condition is well controlled, doctors may evaluate whether to adjust the dose based on the patient's inflammation markers, joint mobility, or imaging results. Some patients can gradually reduce their dose under physician evaluation after reaching low disease activity or clinical remission, but there is still a risk of relapse after complete discontinuation of the drug. Therefore, insisting on follow-up, monitoring indicators and regular evaluation are important prerequisites for determining the length of the long-term medication cycle.

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