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

This study is testing whether combining two drugs — telitacicept (a newer biologic that targets multiple immune pathways) and tofacitinib (a JAK inhibitor) — can help people with severe rheumatoid arthritis that has not responded to at least two prior biologic or targeted therapies. **You may be eligible if...** - You are between 18 and 85 years old - You have been diagnosed with refractory rheumatoid arthritis (RA that has not responded to treatment) - Your RA has not improved with at least two different biologic or targeted treatments - You have voluntarily agreed to participate and signed a consent form **You may NOT be eligible if...** - You have severe disease affecting your heart, liver, or lungs - You have cancer, a blood disorder, or another autoimmune disease besides RA - You are allergic to telitacicept or tofacitinib - You have active tuberculosis or a serious active infection - You are pregnant, breastfeeding, or unwilling to use contraception Talk to your doctor to see if this trial is right for you.