Xeljanz is a drug used to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. It’s also known by its generic name, tofacitinib. It is taken orally, and according to the drug website, helps reduce joint damage, reduces rheumatoid arthritis pain and swelling, and can be taken on its own.  

Xeljanz is taken in a twice-daily dose, but the drug also comes in a once-a-day dose, sold under the name Xeljanz XR. 

Xeljanz XR is a higher-dose, extended-release drug, whereas Xeljanz is a lower-dose medication released into the system more quickly.

How Does Xeljanz Work?

Xeljanz is a biologic medication, which means it’s a type of targeted therapy that contains genetically modified proteins designed to target the immune system cells that attack healthy cells.

Xeljanz is the first biologic treatment for rheumatoid arthritis that can be administered orally. The drug works by stopping the production of the enzyme that causes the inflammation characteristic of rheumatoid arthritis, thereby limiting a major symptom of the disease.

The Xeljanz website calls the drug the “first in a new class of treatments for moderate to severe RA called Janus kinase (JAK) inhibitors.” 

The drug works by interfering with some of the body’s cytokines, which regulate the cells’ responses to infection, inflammation, injuries, and invaders of the immune system. Some of our cytokines worsen our diseases because they induce inflammation. These are the pro-inflammatory cytokines.

Some of our cytokines work to reduce inflammation and initiate healing. These are called the anti-inflammatory cytokines.

Because cytokine receptors are matched with different Janus kinases (JAKs), it’s important that JAK inhibitors such as Xeljanz are targeted to the JAKs responsible for the pro-inflammatory response.

Even though Xeljanz can be effective in reducing inflammation, the drug’s suppression of the immune system can result in serious infections. A patient taking Xeljanz may experience a decreased resistance to bacterial, mycobacterial, fungal and viral infections.

Though most experts in the medical community agree that the drug is a biologic, one study indicates that it’s different from other drugs in the same class and instead found that Xeljanz is not actually a biologic because of how it treats rheumatoid arthritis. 

According to Medical News Today, Xeljanz works by targeting proteins inside the cells, as opposed to other biologic treatments that target proteins outside the cells.

An advantage of Xeljanz is that it can be taken orally. Most other biologics must be administered intravenously.

Does Xeljanz Cause Blood Clots?

Xeljanz has been linked to blood clot–related side effects like deep vein thrombosis (DVT). Patients who experience DVT may require deep vein thrombosis treatment.

Following concerns raised in July 2019 about the drug’s association with blood clots, the U.S. Food and Drug Administration (FDA) approved an update to the Xeljanz warning label. Xeljanz and Xeljanz XR now have a Black Box Warning about the elevated risk of blood clots and death when taken in higher doses.

This warning follows the FDA’s review of data from an ongoing Xeljanz clinical safety trial and an investigation into whether or not Xeljanz could cause blood clots.

Additionally, the FDA has noted that the drug’s approval has been limited to patients with ulcerative colitis who have not responded to other treatments, or for those who have experienced serious side effects with other treatments.

Ulcerative colitis is a bowel disease, and Xeljanz can be used to help reduce symptoms of the condition including diarrhea, rectal bleeding, and stomach pain.

Symptoms of Blood Clots

A blood clot is a glob of blood that has become a semi-solid mass. When the human body experiences injuries, clotting helps prevent the loss of too much blood. However, if a blood clot forms inside the veins, the situation may become life-threatening very quickly.

One type of blood clot is deep vein thrombosis, which means a clot has formed deep inside the body. Many times, deep vein thrombosis occurs in the legs, but it can break away and travel to the lungs or heart where it can become fatal.

A pulmonary embolism is a blood clot in the lungs. According to the Centers for Disease Control and Prevention, nearly 900,000 people in the U.S. suffer from either deep vein thrombosis or pulmonary embolism every year.

A blood clot in the leg or arm may cause swelling, pain, a reddish tinge to the skin and a warm or tender feeling. A pulmonary embolism is marked by an increased heart rate, sudden shortness of breath for no apparent reason, chest pain or coughing up bloody phlegm.

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This article is not legal advice. It is presented 
for informational purposes only.