JAK Inhibitors and Injuries

What Are JAK Inhibitors?

Janus kinase (JAK) inhibitors belong to a family of medications called DMARDs (disease-modifying antirheumatic drugs). The medications are used to help ease joint pain and swelling from rheumatoid arthritis (RA). They work by decreasing an overactive immune system which is the body’s defense against germs. There are three main JAK inhibitor medications – baricitinib (Olumiant), tofacitinib (Xeljanz), and upadacitinib (Rinvoq) – that have been approved by the Food and Drug Administration (FDA) to treat rheumatoid arthritis (RA). 

If you have rheumatoid arthritis, your body produces too many proteins, known as cytokines, that play a role in creating inflammation. Some cytokines attach to receptors on immune cells. When this occurs, the body sends a message to make even more cytokines which causes more inflammation. However, JAK inhibitors stop this process by blocking the messaging pathway that tells the cell to make even more cytokines. This calms down your immune system and helps ease RA symptoms.

JAK Inhibitor Injuries

JAK inhibitors have been linked to an increased risk of venous thromboembolic events.  Unfortunately, there is no warning label about the risk of thromboembolic events on popular JAK inhibitors, including Xeljanz and Jakafi. 

Venous thromboembolism is a condition that is a combination of deep vein thrombosis and pulmonary embolism. Deep vein thrombosis (DVT) occurs when a blood clot forms (usually in the deep veins of the leg, groin, or arm). Pulmonary embolism (PE) occurs when the blood clot breaks off, travels throughout the body, then lodges in the lungs blocking some or all of the blood supply. The combination of DVT and PE forming venous thromboembolism is dangerous and can be potentially fatal. There are 10 million cases of venous thromboembolism every year. 

Symptoms of Deep Vein Thrombosis: 

  • Pain or tenderness (usually starting in the calf) 
  • Swelling (usually in the ankle or foot) 
  • Redness or discoloration 
  • Warmth 

Symptoms of Pulmonary Embolism: 

  • Unexplained shortness of breath 
  • Rapid breathing 
  • Chest pain (usually worse with deep breathing) 
  • Rapid heart rate
  • Lightheadedness or passing out 

Venous Thromboembolic Events Include

  • Pulmonary thrombosis 
  • Pulmonary embolism 
  • Portal vein thrombosis 
  • Deep vein thrombosis 
  • Thrombosis

Popular JAK Inhibitor- Xeljanz

JAK inhibitors such as the popular rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis medication Xeljanz have been potentially linked to an increased likelihood of suffering venous thromboembolic events such as pulmonary thrombosis, pulmonary embolism, portal vein thrombosis, deep vein thrombosis, and thrombosis. The medication has also been linked to a possible increased risk of developing blood clots, strokes, and Major Adverse Cardiac Events (MACE) such as heart attacks and cardiac arrests. 

To learn more about the Xeljanz’s approval history and the study potentially connecting Xeljanz to serious complications, review our Xeljanz Safety Evaluation Timeline

Read more about the MACE injuries that have been linked to Xeljanz. Read more about the blood clots and strokes that have been connected to Xeljanz. 

For information about the Xeljanz lawsuit, check out our Xeljanz Area of Practice page.

How GoldenbergLaw Can Help

If you or a loved one have suffered harm after taking Xeljanz, contact the Dangerous Drug Attorneys at GoldenbergLaw. Our team has over thirty years of experience providing clients with the Gold standard advocacy. We will give you a free consultation and you can leave the sleepless nights to us!

Xeljanz Stroke and Blood Clot Injuries

Popular rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis medication Xeljanz has been potentially linked to causing strokes and blood clots. Review our Xeljanz Safety Evaluation Timeline for more information on the approval history of Xeljanz and the study potentially connecting Xeljanz to strokes and blood clots. Xeljanz is also linked to Major Adverse Cardiac Events (MACE) such as heart attacks and cardiac arrests. Read more on MACE injuries linked to Xeljanz. 

For more information on the Xeljanz lawsuits, review our Xeljanz Area of Practice page.

What Is a Stroke?

A stroke (also known as a ‘brain attack’) is a sudden interruption in the blood supply to the brain that can cause potentially fatal complications. Most strokes are caused by an abrupt blockage of arteries leading to the brain. However, other strokes are caused by bleeding in the brain tissue resulting from a blood vessel bursting. 

This means that the brain is deprived of vital oxygen and nutrients. When this occurs, part of the brain cannot get the blood and oxygen it needs. As a result, brain cells die. 

There are three main types of strokes. Ischemic strokes are the most common (approximately 80% of strokes) and they are caused by a blood vessel leading to the brain becoming narrowed or blocked, causing severely decreased blood flow. The blocked or narrowed blood vessels are usually caused by fatty deposits that build up in blood vessels or blood clots. 

A hemorrhagic stroke occurs when a blood vessel in the brain ruptures. Factors causing brain bleeds include uncontrolled high blood pressure, over-treatment with blood thinners, bulges at weak spots in the walls of the blood vessels, trauma, protein deposits in blood vessels leading to weakened vessel walls, and an ischemic stroke leading to a hemorrhage. 

A transient ischemic attack (TIA) is known as a ‘ministroke.’ It is a temporary period of symptoms similar to those that one experiences if they had a stroke. TIAs usually do not cause permanent damage. They are caused by the temporary decrease in blood supply to part of the brain which can last for as little as five minutes. This occurs when a clot or other debris reduces or blocks the blood flow to part of your nervous system. Having a TIA increases the risk of having a full-blown stroke in the future. 

Lifestyle Risk Factors for Strokes include

  • Being overweight or obese
  • Physical inactivity 
  • Heavy or binge drinking 
  • Use of illegal drugs such as cocaine and methamphetamine 

Medical Risk Factors for Strokes include: 

  • High blood pressure 
  • Smoking cigarettes or being exposed to secondhand smoke 
  • High cholesterol 
  • Diabetes
  • Obstructive sleep apnea
  • Cardiovascular disease such as heart failure, heart defects, heart infection or abnormal heart rhythm such as atrial fibrillation 
  • Personal or family history of stroke, heart attack or transient ischemic attack
  • COVID-19 

General Stroke Symptoms include

  • Trouble speaking and/or understanding what others are saying
  • Paralysis or numbness in the face, arm or leg (often affects just one side of the body) 
  • Vision problems in one or both eyes such as blurred vision, blackened vision, or seeing double 
  • Severe headache 
  • Trouble walking 

Strokes are the fifth leading cause of death and disability in the United States. Nearly 800,000 people have a stroke every year in the U.S. which accounts to one person every 40 seconds. 

A person who suffers a stroke needs immediate emergency medical treatment.

What Can Happen If I Have a Stroke?

The effects of a stroke depend on which part of the brain is injured and how severe the injury is. Different parts of the brain control different areas and functions of the body, and the area of the brain closest to the stroke is usually most seriously impacted. 

Complications of strokes can result in temporary or permanent disabilities. The extent of the disabilities is dependent on how long the brain lacks blood flow and which part of the brain is affected. Complications can include

  • Paralysis or loss of muscle movement on one side of the body 
  • Difficulty talking (aphasia) or swallowing 
  • Difficulty understanding speech, reading or writing 
  • Memory loss
  • Difficulty thinking, reasoning, making judgments, and understanding concepts
  • Clinical depression
  • Pain, numbness, or unusual sensations
  • Changes in behavior and ability to care for oneself 
  • Bladder or bowel control problems
  • Urinary tract infections (UTIs) 
  • Brain swelling (edema)
  • Pneumonia 
  • Seizures
  • Bedsores 
  • Limb contractures 
  • Shoulder pain 
  • Deep venous thrombosis (DVT) 
  • Involuntary muscle tightening or spasticity 
  • Chronic headaches 

However, early action can reduce brain damage and other complications.

What Are Blood Clots?

A blood clot is a clump of blood that is changed from liquid to a gel-like or semisolid state. Platelets (cells that float within the blood) become sticky in response to an injury and begin to attach to each other in addition to the vein or blood vessel. Then web-like strands in the blood (fibrin) attach to the platelets and form a net that traps red blood cells, turning them into a blood clot. 

Blood clotting is a necessary process that prevents a person from losing too much blood in certain instances–such as when an individual is injured or cut. Most blood clots dissolve on their own. 

However, when the blood clot forms inside veins, arteries, or blood vessels, they will not always dissolve on their own. It can be dangerous and life-threatening if the blood clot breaks free, travels through the veins to a limb or internal organ, and prevents blood flow. If your heart, lungs, or brain is deprived of the vital oxygen carried in blood, life-threatening emergencies such as heart attacks or strokes can occur. 

Risk Factors for Blood Clots include: 

  • Age (over age 65) 
  • Lengthy travel requiring a person to sit for more than 4 hours 
  • Bed rest or being sedentary 
  • Obesity 
  • Pregnancy 
  • Personal or family history of blood clots 
  • Smoking
  • Cancer 
  • Certain birth control pills and hormone replacement therapies 
  • Certain breast cancer medicines
  • Certain cancer types, including pancreatic, lung, multiple myeloma, and blood-related cancers) 
  • Trauma from serious injury 
  • Major surgery 
  • Autoimmune disorders 
  • Diseases related to chronic inflammation 
  • Infections such as HIV/AIDS, Hepatitis C, and Lyme’s Disease

Blood clots most commonly form in arms and legs in one of the major deep veins way beneath the skin’s surface. This is known as deep vein thrombosis (DVT). DVT affects up to 900,000 Americans each year and kills approximately 100,000 Americans each year. Unfortunately, a person can have DVT without obvious signs; it usually requires medical guidance to determine if a person has DVT. 

Symptoms of Blood Clots in Arms and Legs: 

  • Swelling
  • The skin changes color (reddish or bluish hue) 
  • Pain 
  • Warm skin 
  • Trouble breathing
  • Bad cough–can even cough up blood 
  • Chest pain 
  • Dizziness 
  • Lower leg cramping 
  • Fluid buildup resulting in swollen, painful veins 
  • Sweating 

Blood clots that start out in deep veins in the arm or leg can break off and travel to the lungs can cause a pulmonary embolism. 

Symptoms of Blood Clots in Lungs include: 

  • Feel short of breath 
  • Breathing problems 
  • Chest pain 
  • Cough 
  • Sweat 
  • Dizziness 

Blood clots that move to the brain are often caused by fatty deposits formed in the walls of blood vessels that bring blood to the brain. They may form because of a blow to the head leading to a concussion. The blood clot can start in any part of the body, travel in the brain, and cause a stroke. 

Symptoms of Blood Clots in the Brain: 

  • Vision problems 
  • Speech problems 
  • Seizures
  • Feeling of weakness 

Blood clots can also appear in the veins that drain blood from the intestines. It can be caused by diverticulitis, liver disease, or some types of birth control pills. 

Symptoms of Blood Clots in the Intestines: 

  • Nausea
  • Vomiting 
  • Severe stomach pain
  • Diarrhea
  • Bloody stool 
  • Bloating

If blood clots occur in the kidneys, they can stop waste from being removed from the body. This can cause high blood pressure or even kidney failure. 

Symptoms of Blood Clots in the Kidneys: 

  • Pain on the side of the belly, legs or thighs 
  • Blood in urine 
  • Fever 
  • Nausea 
  • Vomiting 
  • High blood pressure 
  • Sudden, severe leg swelling 
  • Difficulty breathing

What Can Happen If I Have a Blood Clot?

Complications of blood clots include

  • Pulmonary embolism due to blood clots in the lungs
  • Kidney failure due to blood clots in the kidneys 
  • Deep vein thrombosis (DVT) from blood clots forming in the arms or legs
  • Pregnancy complications 
  • Heart attacks 
  • Strokes

How GoldenbergLaw Can Help

If you or a loved one suffered a stroke or blood clot after taking Xeljanz, contact the Dangerous Drug Attorneys at GoldenbergLaw today. We have over thirty years of experience providing our clients with the Gold standard of advocacy; you can leave the sleepless nights to us!

The Dangers of Winter Weather Premises Liability Accidents

Premises liability cases are among the most common cases the Minneapolis Attorneys at GoldenbergLaw see during Minnesota winters. Slipping and falling on snow and ice on sidewalks, parking lots, and walkways can result in serious injuries. Falling ice and snow from roofs and gutters can also cause serious injuries.

What Is Premises Liability?

Premises liability cases involve an unsafe condition on someone’s property. Property owners are held to the standard of exercising reasonable care in the ownership and maintenance of the property to keep guests reasonably safe. This means that property owners should foresee potential dangers and take action to minimize or eradicate them. Property owners are not just responsible for the building itself, they are also responsible for common areas, parking lots, and sometimes sidewalks. The standard of care applies to personal property owners, businesses, and retailers. If a property owner failed to exercise reasonable care and you or a loved one was harmed as a result, you may have a premises liability claim.

Tips to Avoid Winter Premises Liability Cases on Your Property or Business

  • Keep rock salt available in winter weather 
  • Keep a good snow shovel on hand
  • Keep a good roof rake on hand and regularly remove snow buildups from roof
  • Regularly remove ice dams, icicles, and snow drifts from roof and gutters
  • Keep driveways and sidewalks shoveled during the winter
  • Keep driveways and sidewalks salted during the winter
  • Periodically inspect the property, including common areas
  • Remove/remediate snow and ice within a reasonable time

Common Injuries in Winter Premises Liability Accidents

These injuries include: 

  • Sprains and strains
  • Fractures and broken bones
  • Back and spinal injuries
  • Head and traumatic brain injuries

Sprains and Strains 

Both of these injuries involve the tearing and/or stretching of soft tissue. Sprains impact ligaments, and strains impact the muscles or tendons. Results of these injuries include limited range of motion and immense pain. Sprains and strains most often affect the wrists and ankles in winter weather slip-and-fall accidents. 

Fractures and Broken Bones

Broken or fractured bones can occur when someone slips and falls due to the winter ice and snow. These injuries can also occur from impacts from falling ice and snow. Broken or fractured bones are serious injuries that should be treated immediately, as they can also cause damage to internal organs. 

Back and Spine Injuries

Slip-and-fall accidents are a leading cause of spinal injuries in the United States; they cause about 31% of all new spinal cord injuries every year. If you land on your back, the force of the fall can actually fracture the spinal vertebrae. A fractured vertebrae puts pressure on the spine which can result in immense pain, spasms, incontinence, loss of sensation in limbs, and potentially lifelong paralysis. Other common back injuries from slip-and-fall accidents include herniated, slipped, or compressed discs that can cause severe pain and limited mobility. 

Head and Brain Injuries

In the majority of serious slip-and-fall accidents, the victim’s head collides with the ground. Brain injuries can also occur from impacts from falling ice and snow. These injuries are immensely serious, because they can progressively worsen over time if untreated. If someone injuries their head, they must be examined by a doctor immediately.

Traumatic brain injuries occur when a powerful force acts upon the head in a way that causes damage to the brain. The potentially permanent damage can cause symptoms that affect a person’s cognitive abilities in addition to resulting in concussions, brain contusions, penetrating brain injuries, and more.

How GoldenbergLaw Can Help

If you or a loved one has been harmed on someone else’s property, contact the Minnesota Premises Liability Attorneys at GoldenbergLaw. We have over 35 years of experience and will provide you with the Gold standard of advocacy that you deserve. Contact us today for a free consultation.