Rheumatology (Oxford). 2021;60(4):1708-1716.Long-term evaluation of tofacitinib has found limited progression of structural damage in patients with RA treated with tofacitinib for up to 5 years. Similar results were also observed for patients receiving tofacitinib monotherapy or combination therapy for up to 3 years.It is well known that inflammation in RA leads to structural damage over time, and therapies such as DMARDS have the ability to reduce inflammation whilst inhibiting the progression of structural damage. In this study, van der Heijde, et al. analysed long-term rates of progression of structural damage with the oral JAK inhibitor tofacitinib, based on radiographic data from its long-term extension studies; observing limited radiographic progression and progression of structural damage in tofacitinib-treated patients with RA.