Objective To assess the short-term efficacy of the additional low-dose tofacitinib, based on the original regimen, in persistent monoarthritis after conventional treatment in rheumatoid arthritis (RA) patients. Methods A total of 21 RA patients who had achieved low disease activity or clinical remission after 24 weeks of treatment with conventional synthesis disease-modifying anti-rheumatic drugs (csDMARDs) but still had monoarthritis were selected as the research subjects, and they were treated with additional low-dose tofacitinib (5 mg each time, once daily) on the basis of the original regimen for 24 continuous weeks. The efficacy of patients at different time points [disease activity score in 28 joints (DAS28), visual analogue scale (VAS) score for joint pain, VAS score for patient's overall pain assessment, VAS score for doctor's overall pain assessment, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level in the baseline period, as well as at the 4th, 12th, and 24th weeks after treatment] and improvement of joint pain at different time points (proportions of patients with over 20%, 50%, and 70% increases in VAS score for joint pain from basal at the 4th, 12th, and 24th weeks after treatment) were compared, and the incidences of adverse reactions during treatment were recorded. Results Compared with the basal, patients' DAS28, VAS score for joint pain, VAS score for patient's overall pain assessment, and CRP level were lower at the 4th, 12th, and 24th weeks after treatment, and the VAS score for doctor's overall pain assessment and ESR were lower at the 12th, and 24th weeks after treatment (all P<0.05). The proportion of patients with an over 20% increase in VAS score for joint pain from basal at the 4th, 12th, and 24th weeks after treatment increased sequentially, and the proportions of patients with over 50% and 70% increases in VAS score for joint pain from basal at the three time points also increased successively; compared with those at the 4th week after treatment, the proportions of patients with over 20% and 50% increases in the VAS score for joint pain from basal were higher at the 12th and 24th weeks after treatment, and the proportion of patients with an over 70% increase in the VAS score for joint pain from basal was also higher at the 24th week after treatment (all P<0.05). During treatment, there was 1 case-time of mild liver impairment and 1 case-time of gastrointestinal discomfort, both of which improved after symptomatic treatment. Conclusion The additional low-dose tofacitinib can effectively improve the condition of persistent monoarthritis after conventional treatment in RA patients and has fewer adverse drug reactions.

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