Christina Spicer  |  May 21, 2019

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Blood Clots Overview

Blood clots form when circulation in a blood vessel becomes obstructed or restricted, which can cause a buildup in an artery or vein.

According to the Mayo Clinic, there are a number of situations that can cause blood clots to form including disease and injury, with the condition being potentially life threatening if they are not resolved.

One of the most common conditions associated with blood clots is venous thrombosis, which occurs when a person becomes unable to move and muscle contraction fails to circulate blood into the heart. The paused blood flow can then form clots along the walls of the vein and can grow into a partial or complete blockage.

According to medicinenet.com, blood clots that form in veins are typically due to two primary reasons; immobility and genetic errors in the body’s clotting mechanism. Immobility refers to when the body stops moving for a prolonged period of time, which can cause blood to stagnate due to lack of muscle movement, which pumps blood to the heart. Genetic conditions that may make the person more prone to blood clotting, which is often referred to as hypercoagulation.

However, it is important to note that blood clots that form in an artery, called arterial thrombus, occur in a completely different manner. Arterial thrombus stops circulatory function to other tissues beyond the blockage, which prevents cells from receiving much needed oxygen and nutrients.

One of the most commonly associated disease is atherosclerotic disease, in which plaque deposits form along the lining of the artery and compound until the blood vessel narrows. This can lead to a multitude of other serious conditions like stroke or peripheral artery disease (PAD), with blood clots able to form in the a plaque ruptures and completely or partially cuts off circulation.

Depending on the disease, blood clots can be caused by a number of problems with most of them being attributed to lifestyle choices like diet and exercise routines. However, sometimes blood clots can form due to diseases like diabetes or similar conditions that make patients more vulnerable.

Link to Rheumatoid Arthritis Medication

Blood clots have recently become associated with the popular rheumatoid arthritis medication Xeljanz and Xeljanz XR, with the FDA issuing a recent warning on Feb. 25, 2019.

More specifically, the FDA announced that a clinical trial indicated patients taking Xeljanz at 10 mg twice a day faced a greater risk of blood clot formation in the lungs, compared to other medications. It is important to note that this trial is currently ongoing, and is expected to be completed by the end of 2019.

Xeljanz works by acting as a blocker against enzymes called Janus kinases in the immune system, which contributes to joint inflammation that RA patients commonly experience. Rheumatoid arthritis, or RA, is an autoimmune disease that attacks the joints, which creates inflammation in the tissue in the lines inside of joints.

According to arthritis.org, this causes painful joint swelling, which can potentially damage bone and cartilage if not treated. Without sufficient cartilage, joint spacing becomes smaller and become can cause patients to experience significant pain during mobility.

Approximately 1.5 million people suffer from RA in the United States, which makes the recent association between Xeljanz and blood clots very troubling for the medical community.

Xeljanz patients are being advised to be wary of any signs or symptoms of blood clots including, but not limited to:

  • Chest or Back Pain
  • Coughing up Blood
  • Breathing Difficulty
  • Excessive Sweating
  • Shortness of Breath
  • Blueish Skin
  • Clammy Skin

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