Tofacitinib is a drug used for treating rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. It is also known by its brand name, Xeljanz. It helps to reduce joint damage, and reduce rheumatoid arthritis pain and swelling.

The drug is taken in pill form, either once or twice daily. In its once-daily dosage, it is sold under the brand name Xeljanz XR.

How Does Tofacitinib Work?

Inflammation is an immune system response, and tofacitinib is used for treating this response. MD Peer Exchange explains that an overactive immune system contributes to rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.

Tofacitinib is a biologic mediation — more specifically, it is a Janus kinase inhibitor, which means that it delivers a genetically modified protein to target the immune system cells that attack healthy cells. It prevents inflammatory enzymes from stimulating an immune response, thereby reducing arthritis symptoms.

Is Tofacitinib Safe?

Tofacitinib weakens the immune system, so it has serious risks. It can leave patients vulnerable to infections, something especially concerning for patients who may already be predisposed.

DailyMed.com notes that people over the age of 65, and those with diabetes, may be more likely to develop an infection than other patients. 

And Medical News Today says that because the drug affects the immune system, patients with low lymphocyte (white blood cell) levels should not use the drug, because it could further affect their immune system.  

Unfortunately, use of tofacitinib may be linked to a higher risk of lymphoma and non-melanoma skin cancer.

Additionally, the drug may be linked to an increased risk for developing blood clots in the lungs, or an increased risk for pulmonary embolism.

Is Tofacitinib a First Line of Treatment?

Tofacitinib was first approved for use in rheumatoid arthritis in patients who did not respond to other drugs. This limitation was put in place because the drug has been linked to a higher risk of blood clots.

It was then approved for use in patients with ulcerative colitis, but the U.S. Food and Drug Administration (FDA) recently released warnings about tofacitinib used for patients with this condition. Reportedly, ulcerative colitis patients taking tofacitinib also have an increased risk of developing blood clots. As a result, the FDA has limited its use in people with ulcerative colitis. Only those who did not have success with other medications, either because the drugs didn’t work or caused severe side effects. 

MDmag.com reports that symptoms include shortness of breath, pain in the chest that gets worse during breathing, and swelling in the legs and arms. Reportedly, the FDA has received notice of 19 cases of blood clots in the lungs and 45 deaths among 3,884 people who took 10 mg of tofacitinib as part of a safety trial, numbers which were much higher than those associated with another arthritis drug. 

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