Co-Occurrence Patterns of Symptom and Functional Burden Associated with Tofacitinib and Upadacitinib: A Multidimensional Analysis of Spontaneous Reports in Rheumatoid Arthritis

Background/Objectives: Pharmacovigilance studies typically evaluate adverse events as isolated drug-event pairs, potentially overlooking symptoms and functional impairments reported concurrently within the same case. We investigated co-reported adverse event patterns for tofacitinib and upadacitinib in patients with rheumatoid arthritis (RA).

Methods

FAERS reports submitted between 2004 and 2025 were included if tofacitinib or upadacitinib was recorded as the primary suspect drug for RA. Disproportionality analysis was integrated with three co-occurrence network approaches, Bayesian network analysis, and time-to-onset (TTO) analysis. Methotrexate served as an indication-matched comparator. Network analyses were stratified by reporter and submission type, and TTO was reassessed for the common 2019-2025 period. FAERS signals were also compared descriptively with Canada Vigilance data.