Efficacy and Safety of Telitacicept Combined With Baricitinib 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