A b s t r a c t Objectives: In a low-income country like Bangladesh; the study was taken place in a private rheumatology center between 1st January 2016 to 31st December of 2016 includes 85 Rheumatoid Arthritis (RA). The aim of the study was to observe and statistically analyze the response to treatment with different types of disease-modifying antirheumatic drugs (DMARDs). Initially the patients were treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) like Methotrexate (MTX), Leflunomide (LEF), Sulfasalazine (SSZ) and Hydroxychloroquine (HCQ). Since the biological disease-modifying antirheumatic drugs were expensive and not affordable by most of the refractory to csDMARDs patients, these patients were treated with a single Janus kinase (JAK) inhibitor; a targeted synthetic (tsDMARD) Tofacitinib (TOFA) when the drug available in Bangladesh in July 2016. Treatment response was assessed by use of disease activity score of 28 joints (DAS28) using Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP). The adverse effects of different DMARDs, patients’ residence (urban or village) with their monthly income; lastly attendance rate of the patients for timely follow-up were assessed. Methods: An observational, prospective cohort study was performed. After obtaining the informed consent of individual patient; history taking, direct clinical examination, interview of the patients and clinical disease activity, adverse effects etc. were recorded and statistically analyzed. Results: The mean age at diagnosis was 40.68±13.56 years; mostly females (n=69, 81.18%). Majority of the patients had obtained post-primary education (n=67, 78.82%). Two-third patients (n=66, 77.65%) were house wives; funded by their husbands. Majority of the patients (n=73, 85.88%) had moderate to severe impairment of activities of daily living (ADL) at the time of enrollment with moderate to high disease activity. Most of the patients (n=77, 90.59%) had a positive rheumatoid factor test at recruitment and considerable number of patients (n=53, 62.35%) had a positive anti-cyclic citrullinated peptide (ACPA) test. Eighteen patients (21.18%) were in remission with DAS28 score