What is Xeljanz?
Xeljanz is a medication intended to treat moderate-to-severe forms of rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. It is an immunosuppressant with the active ingredient tofacitinib and is part of the class of drugs known as Janus kinase (JAK) inhibitors.
How Does Xeljanz Work?
Xeljanz works by decreasing a substance called cytokines. Cytokines are proteins that help control the immune system. People with rheumatoid arthritis make more cytokines than needed, which leads to inflammation and pain. Xeljanz disrupts cell signals in the Janus kinase (JAK) pathways to decrease the production of cytokines.
Background on Xeljanz
The U.S. Food and Drug Administration (FDA) approved the medication in 2012 for rheumatoid arthritis patients who were not responding to other medications on the market at the time. In 2017, the FDA expanded its approval of Xeljanz and allowed the drug to be prescribed to patients with psoriatic arthritis, a condition that causes joint swelling or pain. The FDA expanded its approval once again in 2018 to treat ulcerative colitis.
Despite the FDA’s continued approval, however, the FDA had lingering concerns about Xeljanz and ordered a phase IV, post-market study to be conducted by Xeljanz’s manufacturer, Pfizer.
FDA Xeljanz Clinical Safety Study
The FDA’s study began in March 2014 and recently concluded. It included patients with active moderate-to-severe rheumatoid arthritis who were 50 years or older and had at least one cardiovascular risk factor.
The final results have not been published publicly. However, preliminary data shows that rheumatoid arthritis patients have up to six times the risk of developing a pulmonary embolism when taking the drug’s 10mg dose twice a day compared to patients taking another medication. Patients taking the 5mg twice daily dose have approximately three times the risk of pulmonary embolism.
Pulmonary embolisms are dangerous blood clots that travel to the lungs. Those who suffer from pulmonary embolisms may have an irregular heartbeat, experience chest pain and trouble breathing, feel faint or lightheaded, cough up blood, and experience pain, swelling, tenderness, and redness in parts of the body where the blood formed or traveled. These blood clots can be life-threatening, and those suffering from pulmonary embolisms should seek immediate medical attention.
The FDA announced that it will continue to review the study’s results and communicate its final conclusions and recommendations in the future.
Xeljanz FDA Safety Clinical Trial Timeline
February 25, 2019: The FDA found that patients taking a dose of 10mg of Xeljanz twice daily may experience an increased risk of developing blood clots in the lungs and therefore issued a safety announcement. Participants in the study were all over 50 years old and each had at least one cardiovascular risk factor. The participants were taking either the 5mg twice daily dose or the 10mg twice daily dose of Xeljanz and were then compared to a similar group of participants on a tumor necrosis factor (TNF) inhibitor. Three days after the safety announcement from the FDA alerting the public to the increased risk of pulmonary embolism and death, Xeljanz’s manufacturer, Pfizer, sent a letter advising healthcare providers of the same risks.
July 26, 2019: The FDA issued a Black Box Warning for the 10mg twice daily dose of Xeljanz. The black box warning focused on the increased risk of blood clots and death in people with rheumatoid arthritis over 50 years old with at least one cardiovascular risk factor. The black box warning limited the use of the 10mg twice daily dose of Xeljanz to treating ulcerative colitis patients whose condition was not already being sufficiently managed by other medications. As a result, the FDA discontinued the evaluation of the 10mg twice daily dose of Xeljanz in the ongoing clinical trial and switched the participants to the 5mg twice daily dose.
February 4, 2021: The FDA issued a safety communication warning the public about the initial results from the ongoing Xeljanz study. The initial results found that there is an increased risk of heart-related problems and cancer in patients taking Xeljanz. The trial compared patients taking the 5mg twice daily and 10mg twice daily doses of Xeljanz to patients taking a tumor necrosis factor (TNF) inhibitor. The participants were all over age 50 and had at least one cardiovascular risk factor. Full results from the clinical trial are not yet available. However, the FDA is recommending that patients continue taking Xeljanz as they were prescribed by their physicians but also to consult their healthcare providers if they have questions or concerns.
How GoldenbergLaw Can Help
If you or a loved one suffered harm after taking Xeljanz, contact the Minnesota Xeljanz Attorneys at GoldenbergLaw today for a free consultation. We have provided Gold standard advocacy for more than 30 years! Contact us today, and you can leave the sleepless nights to us!