Xeljanz For Other Conditions
In addition to the uses listed above, Xeljanz and Xeljanz XR may be used off-label. Off-label drug use is when a drug thats approved for one use is used for a different one thats not approved. You may wonder if Xeljanz or Xeljanz XR is used for certain other conditions.
Xeljanz for alopecia
Xeljanz and Xeljanz XR arent approved to treat alopecia , but sometimes theyre used off-label for this condition. A review of found that tofacitinib may be effective to treat alopecia. However, more studies are needed to fully understand the role of these drugs in treating hair loss.
If youd like to know more about treatment options for hair loss, talk with your doctor.
Xeljanz for psoriasis
Xeljanz and Xeljanz XR arent approved to treat psoriasis, but sometimes theyre used off-label for this condition. However, Xeljanz and Xeljanz XR are approved to treat psoriatic arthritis , which is closely related to psoriasis.
In a of six clinical studies, tofacitinib was found to be more effective than a placebo in treating plaque psoriasis.
If youd like to know more about treatment options for psoriasis, talk with your doctor.
Xeljanz for vitiligo
Xeljanz and Xeljanz XR arent approved to treat vitiligo, which is condition where your skin loses pigmentation in some areas. However, both drugs are sometimes used off-label for this condition.
If youd like to know more about treatment options for vitiligo, talk with your doctor.
Xeljanz for lupus
Xeljanz for eczema
Safety / Side Effects
If you are considering asking your doctor about XELJANZ, itâs important to learn more about the risks and benefits. The tools below can provide helpful information about taking XELJANZ and the safety and side effects of treatment.
The safety information below applies to all marketed formulations of XELJANZ. Specific risks associated with certain dosing are noted.
Tofacitinib In Special Circumstances
Use in acute severe UC
The rapid onset of action and short half-life have raised the prospect of using tofacitinib in the management of acute severe UC . Data remain limited to a few case reports.30,6064 In three case series, 14 of 15 patients received 3 days high-dose intravenous steroids prior to rescue tofacitinib with a history of anti-TNF failure.30 Eleven patients received standard induction dosing 10 mg BD, whereas the Michigan group used a higher dose of 10 mg three times daily.30,60 Following tofacitinib rescue therapy, 13% required colectomy during that index admission and 20% within 6 months, with no difference in colectomy rates according to tofacitinib dose.30 At the last follow-up, 47% remained in CFCR on maintenance therapy.30 Kotwani et al. reported endoscopic remission in addition to CFCR at last follow-up in 2 of the 4 patients included in their small case series.63 Overall, no major AEs were reported and notably no new thromboembolic events.30,61,64
More recently, a retrospective casecontrol study evaluated the efficacy of tofacitinib induction therapy in hospitalized patients with biologic-experienced ASUC.65 Compared to matched controls, there was a lower 90-day colectomy rate in the 40 patients who received tofacitinib with intravenous corticosteroids . The benefit was only statistically significant at tofacitinib 10 mg three times daily and not at 10 mg BD dosing.65
Post-operative surgical outcomes
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Tofacitinib For Severe Ulcerative Colitis: Will It Prevent Colectomies
Gastrointestinal experts explore the benefits of the drug when treating patients with acute severe ulcerative colitis.
Acute severe ulcerative colitis, or ASUC, can be extremely debilitating. Symptoms for the condition range from frequent bloody bowel movements to anemia, weight loss, and even fevers and chills. And nearly 30% of individuals who develop an episode of ASUC require a colectomy, which is a surgery that involves removing parts, or all, of your colon.
When someone with ASUC has a colectomy, its irreversible and certainly can have a huge impact on the quality of their life, said Jeffrey Berinstein, M.D., a gastroenterologist and clinical lecturer at Michigan Medicine. Janus kinase inhibitors, which are better known as JAK inhibitors, are drugs that work to inhibit the activity of certain enzymes. The JAK inhibitor, tofacitinib, has shown itself to be an effective drug when treating ASUC. But I teamed up with several of my colleagues, including Peter Higgins, M.D., Ph.D., to truly examine if its use could prevent individuals from having this life-altering surgery.
The teams research on tofacitinib was recently published in Clinical Gastroenterology and Hepatology.
According to Berinstein, ASUC is considered a medical emergency and requires treatment quite quickly.
Uc Flares & Remission
Remission means those times when you arenât having a flare and your UC symptoms are under control. But just because UC goes into remission doesnât mean there isnât a possibility for a flare to happen in the future.
An ulcerative colitis flare, or flare-up, is the return of UC symptoms after a period of remission
Talk to your gastroenterologist and discuss your treatment goals. Establishing goals is an important part of making sure you are getting the most out of how you and your doctor manage your UC.
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What Should I Ask My Doctor
If you have ulcerative colitis, you may want to ask your healthcare provider:
- How much of my large intestine is affected?
- What risks or side effects can I expect from the medication?
- Should I change my diet?
- Will ulcerative colitis affect my ability to get pregnant?
- What can I do at home to manage my symptoms?
- What are my surgical options?
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How Can I Prevent Infections While Im Taking Xeljanz
Its important to try to prevent infections while youre taking Xeljanz or Xeljanz XR. This is because both are immunosuppressants .
The recommends several easy ways to reduce your risk of getting an infection:
- Wash your hands with soap and water:
- before preparing or eating food
- after changing diapers or using the restroom
- after touching any items that have been in contact with people who are sick
Talk with your doctor about specific ways that you can prevent infections in your daily life.
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What Does Xeljanz Cost
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Xeljanz and Xeljanz XR manufacturers website to see if they have support options.
If you have certain autoimmune conditions, your doctor may prescribe Xeljanz or Xeljanz XR for you. These prescription drugs are used in adults and some children.
Xeljanz and Xeljanz XR are used in adults with:
In addition, Xeljanz can be prescribed for children ages 2 years old and older with polyarticular course juvenile idiopathic arthritis. This condition is a type of arthritis that affects children. And being polyarticular, it affects many joints in their body.
With autoimmune conditions, your immune system attacks tissues in your own body and causes inflammation. Xeljanz and Xeljanz XR work to treat certain autoimmune conditions by blocking inflammatory responses inside your body.
Note: Xeljanz and Xeljanz XR should not be used together with other strong immunosuppressant drugs. This includes azathioprine and cyclosporine. In addition, Xeljanz and Xeljanz XR should not be used with biologicdisease-modifying antirheumatic drugs . Talk with your doctor about which medications are safe to use with Xeljanz or Xeljanz XR.
Find answers to some commonly asked questions about Xeljanz and Xeljanz XR.
If I Stop Taking Xeljanz Will I Have Withdrawal Symptoms
No, you shouldnt experience withdrawal symptoms after stopping Xeljanz or Xeljanz XR.
That said, you may notice that symptoms of your condition worsen after you stop taking Xeljanz or Xeljanz XR.
For example, if you are taking Xeljanz for rheumatoid arthritis and you stop the medication, you may experience side effects from stopping Xeljanz treatment. In this case, your RA symptoms may worsen, but this isnt considered withdrawal. One study showed that over half of people with RA who stopped Xeljanz had a flare of their RA symptoms.
If youre taking Xeljanz and are interested in stopping treatment, talk with your doctor. They may be able to recommend ways to avoid having your condition worsen. In some cases, your doctor may recommend another treatment option for you.
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What They Are And How They Treat Uc
In a person with UC, the immune system is overactive and mistakenly attacks cells in the body.
Biologics are medications that attack specific cells and proteins in the immune system that cause inflammatory disease processes. For this reason, doctors also refer to treatment with biologics as .
Usually, a doctor would prescribe biologics to treat adults who have moderate-to-severe UC. There are different types of biologics that may fit a person best on the basis of their symptoms. These include:
- anti-tumor necrosis factor agents
- integrin receptor antagonists
|Intravenous infusion. First three doses at 0, 2, and 6 weeks.From then on: Every 8 weeks.
A doctor may prescribe adalimumab if a person did not respond well to other immune suppressors, such as corticosteroids, azathioprine , or 6-mercaptopurine .
In a clinical study, more than of participants with UC who took adalimumab experienced remission after 52 weeks of the treatment.
A person can self-administer the injections at home after receiving instructions from a healthcare professional.
A doctor may prescribe golimumab for people who need continuous steroid treatment or for people who have not found other UC medications effective.
In a clinical trial, after , more people from the group that took golimumab than those from the group who did not experience:
- a response to the treatment
- a remission of UC symptoms
- improvements in the appearance of the intestines on endoscopy imaging
Does Xeljanz Cause Hair Growth Or Hair Loss
It depends. Some studies have shown that people with alopecia may benefit from taking tofacitinib, the active drug in Xeljanz and Xeljanz XR. Alopecia is an autoimmune disease that causes hair loss. At this time, Xeljanz isnt approved to treat alopecia.
If youre concerned about hair loss, talk with your doctor. They may be able to recommend medications to decrease hair loss.
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What Are The Potential Benefits Of Taking Jak Inhibitors
In people with UC, an overactive immune response can cause the immune system to attack healthy tissue in the large intestine.
Cytokines play a role in this process. These proteins attach to receptors on the JAK-signal transducer and activator of transcription pathway. This triggers an immune response and can cause the inflammation associated with a number of autoimmune and inflammatory conditions.
JAK inhibitors block cytokines from attaching to receptors in the JAK-STAT pathway. This reduces the amount of inflammation the immune system produces. JAK inhibitors are a treatment option for conditions involving an overactive immune response.
Research has found that JAK inhibitors can help reduce inflammation and relieve symptoms in UC. For some people, they may provide a more effective treatment than biologics.
In a 2012 phase 2 clinical trial, 194 people with moderate to severe UC received Xeljanz or a placebo twice a day for 8 weeks. Clinical remission occurred in:
- 33% of people who received 3-milligram doses of Xeljanz
- 48% of people who received 10-mg doses of Xeljanz
- 41% of people who received 15-mg doses of Xeljanz
- 10% of people who received a placebo
Clinical remission means that the symptoms have resolved completely or nearly completely.
A series of three phase 3 clinical trials also found that Xeljanz was effective in inducing and maintaining remission in UC.
- 16.6% to 18.5% of people who received Xeljanz
- 3.6% to 8.2% of people who received a placebo
Should I Avoid Certain Vaccines During Xeljanz Treatment
Yes, you should avoid getting live vaccines during Xeljanz or Xeljanz XR treatment. Live vaccines contain weakened particles of live viruses or bacteria. These particles cause your immune system to react against that particular virus or bacteria. This is how your body develops immunity to protect you from the condition you were vaccinated for.
When youre taking Xeljanz or Xeljanz XR, your immune system isnt as effective at fighting infections. If you get a live vaccine during your treatment, you may end up getting infected by the virus or bacteria that the vaccine is meant to protect you from.
Examples of live vaccines include:
Before starting Xeljanz or Xeljanz XR treatment, talk with your doctor about your vaccination history. Theyll make sure that youre up to date on your vaccines before you start taking either drug.
Xeljanz use before and during pregnancy hasnt been studied in humans. Some results from animal studies are described below.
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Medical Management Of Ulcerative Colitis
Therapeutic decisions depend on disease activity and extent. Disease activity is best evaluated objectively using a clinical activity index . Patients with severe disease require hospital admission, whereas those with mild/moderate disease can generally be managed as outpatients.
Disease extent can broadly be divided into distal and more extensive disease. Topical management is appropriate for some patients with active disease. This is usually the case for those with proctitis and often the case if the disease extends into the sigmoid. For those with more extensive disease, oral or parenteral therapy are the mainstays of treatment, although some of these patients may get additional benefit from topical therapy.
Study Design And Patients
This was a single-centre retrospective study conducted between November 2005 and December 2020. Patients diagnosed with CD or UC aged> 18 years and managed at Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, were eligible . Patients had moderately to severely active disease, defined by a Mayo score of 612 for UC and a Crohns disease activity index of 220 or higher for CD. They had also received at least one injection of infliximab, adalimumab, or golimumab as induction treatment, and anti-TNF therapy had been discontinued as the first-line treatment due to a primary non-response, secondary loss of response, occurrence of side effects or malignant tumours, or pregnancy. Those who had not previously used an anti-TNF agent or had been followed-up for< 16 weeks were excluded.
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What Should I Tell My Doctor Before Taking Xeljanz
Before taking Xeljanz, Xeljanz XR and Xeljanz oral solution, tell your healthcare provider about all of your medical conditions, including if you:
- have an infection. See “Important information” above.
- are a current or past smoker.
- have had any type of cancer.
- have had a heart attack, other heart problems or stroke.
- have had blood clots in the veins of your legs, arms, or lungs, or clots in the arteries in the past.
- have liver problems.
- have kidney problems.
- have any stomach area pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines.
- have had a reaction to tofacitinib or any of the other inactive ingredients in your medication.
- have recently received or are scheduled to receive a vaccine. People who take these medications should not receive live vaccines. People taking Xeljanz, Xeljanz XR and Xeljanz oral solution can receive non-live vaccines.
Will I Be Monitored
Prior to starting tofacitinib you should expect to be screened for various things. Blood tests to check your kidney function and blood count, and screening for tuberculosis may be carried out.
You should also be offered blood tests after taking tofacitinib for eight weeks and then every three months during treatment. This is to monitor your red and white blood cells as tofacitinib can cause a reduction in these. Tofacitinib can increase cholesterol levels for some people, so your cholesterol levels and liver function should be monitored too.
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What If I Miss A Dose
If you miss a dose of Xeljanz or Xeljanz XR, let your healthcare professional know. Theyll recommend whether you should take the missed dose or wait until your next regular dose. Dont take more than one dose of Xeljanz or Xeljanz XR at a time. This can lead to serious side effects.
To help make sure that you dont miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
How Does This Medication Work What Will It Do For Me
Tofacitinib belongs to the class of medications called immunomodulators or selective immunosuppressants. It is usually used in combination with methotrexate to when methotrexate and at least one other disease modifying medication has not been effective or tolerated. Tofacitinib is used to treat active psoriatic arthritis in combination with methotrexate or other therapies when other treatments have not been effective. It is also used to treat moderate-to-severe active ulcerative colitis when other treatments for UC have failed or the effectiveness has decreased.
Tofacitinib works by blocking the activity of an enzyme called Janus kinase. This enzyme is responsible for sending inflammatory signals in the body. Blocking this enzyme helps to decrease the immune reaction which causes rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
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