Xeljanz for Autoimmune Diseases: How It Works, Who It’s For, and What to Expect

Are you living with autoimmune conditions such as rheumatoid arthritis, ulcerative colitis, or psoriatic arthritis, and finding that the medications you’ve taken haven’t provided enough relief? If so, Xeljanz might be the solution you’re looking for. This FDA-approved medicine can help reduce inflammation, ease pain, and improve the quality of your daily life. In this article, we’ll cover everything you need to know about Xeljanz, including its dosing, side effects, cost, and much more.

What Is Xeljanz?

Xeljanz (tofacitinib) is an FDA-approved medicine used to treat certain autoimmune and inflammatory conditions. The FDA first approved this drug on November 6, 2012 [1]. Xeljanz can treat rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, ulcerative colitis, ankylosing spondylitis, and psoriatic arthritis. You can use Xeljanz when other treatments haven’t worked well or caused too many side effects.

Xeljanz belongs to a class of drugs known as Janus kinase (JAK) inhibitors. It works by blocking specific enzymes that play a role in causing inflammation in the body. By doing so, it helps reduce inflammation, relieve pain, and improve daily life in people with the above-mentioned diseases.

What Is Xeljanz Used To Treat?

Xeljanz (tofacitinib) is a prescription medication. It is FDA-approved to treat the following conditions in patients who have received one or more TNF (tumor necrosis factor) blocker medications without adequate relief of symptoms or intolerable side effects [2]:

Rheumatoid Arthritis: This is a long-term autoimmune condition that causes inflammation in your joints. Doctors can use Xeljanz to treat adult patients with moderate to severe rheumatoid arthritis.

Psoriatic Arthritis: This is a long-term condition that causes joint pain, stiffness, and swelling. Xeljanz is used to treat adult patients with active psoriatic arthritis.

Ulcerative Colitis: Ulcerative Colitis is a chronic disease that causes inflammation in your colon and rectum. You may experience symptoms like stomach pain, diarrhea, pain in the rectum, etc. Doctors use Xeljanz to treat adult patients with moderate to severe ulcerative colitis.

Ankylosing Spondylitis: This is a form of arthritis in which your spine and other areas of your body become inflamed. Xeljanz is approved to treat adult patients with active ankylosing spondylitis.

Polyarticular Course Juvenile Idiopathic Arthritis: This is a type of arthritis that affects children. In this condition, five or more joints become inflamed. Xeljanz Oral Solution is used in children 2 years of age or older.

How Does It Work?

Autoimmune diseases occur when your immune system mistakenly attacks your own body. This leads to inflammation in your joints, intestines, skin, and other organs. A group of enzymes called Janus kinases (JAKs) helps send signals inside cells that lead to inflammation.

The active ingredient in Xeljanz is tofacitinib, which is a JAK inhibitor. It works by blocking the action of JAK enzymes. This helps reduce the production of inflammatory chemicals in your body, which in turn lowers inflammation, pain, and joint damage [2].

Side Effects

Like any other medication, Xeljanz can also have some side effects. Here are some common and severe side effects [2][3]:

Common Side Effects

• Headache
• Diarrhea
• High blood pressure
• Acne
• Upper respiratory tract infections, such as the common cold
• Increased cholesterol levels
• Herpes zoster, also known as shingles

Severe Side Effects

Serious Infection: Xeljanz can increase your risk of developing serious infections, including tuberculosis (TB), shingles, pneumonia, and fungal infections. The risk is even higher if you also take immunosuppressant drugs like corticosteroids.

Cancer: Xeljanz can increase your risk of developing certain cancers, like lymphoma and lung cancer, by changing how your immune system works. If you are a current or past smoker, the risk is even higher. Some symptoms of cancer include unexpected weight loss, repeated infections, and fatigue.

Blood Clots: Xeljanz can increase the risk of blood clots in your lungs, legs, or arms. This can be deadly. The risk is even higher if you are 50 years of age or older with at least one heart disease risk factor. Symptoms of blood clots include shortness of breath, chest pain, and pain and swelling in your arms or legs.

Tears in the Stomach: Xeljanz may increase the risk of tears in your stomach or intestines. The risk is even higher if you take corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or methotrexate. If you have any signs of tears, such as persistent stomach pain, fever, or changed bowel habits, contact your doctor immediately.

Heart Problems: Xeljanz can increase the risk of heart attack or stroke, especially in patients aged 50 or above who have at least one heart disease risk factor. Symptoms of a heart attack or stroke include chest pain, sudden weakness on one side of your body, a feeling of lightheadedness, and slurred speech.

Please note that this is not a complete list of all possible side effects. Contact your doctor right away if you encounter any severe side effects.

Dosing of Xeljanz

The dosage of Xeljanz depends on several factors, including your age, condition, and kidney or liver function. It is available as an oral tablet and oral solution. Here is the usual recommended dosage [2]:

Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis: The recommended dose is Xeljanz 5 mg twice daily or Xeljanz XR (extended-release) 11 mg once daily. If you have moderate to severe kidney problems or moderate liver problems, then the dose would be 5 mg once daily.

Ulcerative Colitis: The starting (induction) dose is Xeljanz 10 mg twice daily or Xeljanz XR 22 mg once daily for 8 weeks. If needed, you can continue this dose for a maximum of 16 weeks. After that, you have to switch to the maintenance dose, which is Xeljanz 5 mg twice daily or Xeljanz XR 11 mg once daily.

Polyarticular Course Juvenile Idiopathic Arthritis: Xeljanz Oral solution is preferred. The dose is 5 mg twice daily or a weight-based equivalent (determined by your doctor) twice daily.

Please note that the dosage needs to be adjusted if you have kidney or liver problems or if you are taking certain other medications. Always follow your doctor’s advice.

Cost

Xeljanz is a high-cost medication. In the United States, a 30-day supply of Xeljanz 5 mg (60 tablets) can cost over $6,000 if you don’t have insurance [4]. However, the actual cost of treatment will depend on your insurance coverage, location, treatment plan, and the pharmacy you visit.

FAQs

Here are some frequently asked questions about Xeljanz:

1. Is Xeljanz an Immunosuppressant?

Yes. Xeljanz (tofacitinib) is an immunosuppressant drug. It lowers your body’s ability to fight off infections. That is why regular monitoring and caution are important during your treatment with this medication.

2. How long does it take for Xeljanz to work?

The response time to Xeljanz varies depending on the individual and the condition being treated. For ulcerative colitis, it can take up to 8 weeks or longer to work. In the case of arthritis-related conditions, some patients may begin to experience symptom relief within 2 weeks, while others may take 3 to 4 months to see noticeable results [2]. 

3. Can I take Xeljanz during pregnancy and breastfeeding?

No. Xeljanz may harm your unborn child, so you should not take it during pregnancy. Also, breastfeeding is not recommended while taking Xeljanz and for at least 18 hours after the last dose, as the medication can pass into breast milk and may affect your baby [2].

4. Can I take vaccines while on Xeljanz?

Xeljanz weakens your immune system’s ability to fight foreign pathogens like viruses and bacteria. This is why you should avoid live vaccines while on this medication. However, non-live vaccines are generally considered safe, and you can receive them. Always consult your doctor before getting any vaccine while on Xeljanz.