Efficacy and Safety of Telitacicept Combined With Tofacitinib for Refractory Rheumatoid Arthritis

Inclusion Criteria: 1. Age 18-85 years 2. Diagnosed with refractory rheumatoid arthritis according to the 2021 EULAR (European Alliance of Associations for Rheumatology) diagnostic criteria 3. The traditional disease-improving rheumatic drug treatment is ineffective, and the use of two or more biological/targeted disease-improving anti-rheumatic drugs is ineffective, and telitacicept combined with tofacitinib is required treated patients 4. Voluntarily provided written informed consent - Exclusion Criteria: 1. Exclusion of patients with severe diseases of major organs (e.g., heart, liver, or lungs) 2. Patients with malignancies, hematological disorders, or other autoimmune diseases (excluding rheumatoid arthritis) 3. History of allergy/hypersensitivity to the study medications (Telitacicept or Tofacitinib) 4. Active tuberculosis or active infectious diseases requiring systemic treatment 5. Pregnancy, lactation, or refusal to use contraception during the study 6. Failure to complete the prescribed Telitacicept + Tofacitinib regimen due to: Non-adherence or Severe adverse reactions 7. Other conditions contraindicating participation per investigator judgment -