Treatment for Xeljanz Injuries

Popular rheumatoid arthritis, psoriatic arthritis, and ulcerative medication Xeljanz has been potentially linked to MACE injuries, strokes, and blood clots through a clinical study. These injuries require extensive treatment. 

Read our Xeljanz Safety Evaluation Timeline for additional information on the approval history of Xeljanz and the study that has potentially connected the popular medication Xeljanz to strokes, blood clots, and MACE injuries such as heart attacks and cardiac arrests. 

For additional information on the Xeljanz lawsuits, see our Xeljanz Area of Practice page.

Treatment for MACE Injuries

Major Adverse Cardiac Events (MACE) injuries include: 

  • Heart attack (myocardial infarction) 
  • Cardiac arrest
  • Acute coronary syndrome 
  • Aortic dissection 

Treatment for Heart Attacks

Treatment for a heart attack can include

  • Cardiac catheterization
  • Angioplasty 
  • Stent placement 
  • Heart bypass surgery 
  • Heart valve surgery 
  • Pacemaker placement
  • Heart transplant

Cardiac catheterization

Cardiac catheterization involves a probe being inserted into the blood vessel through a soft flexible tube known as a catheter. This allows the doctor to find the plaque buildup. The doctor may also inject dye into arteries through the catheter and take an X-ray to see how the blood is flowing and determine if there are any blockages. 

Angioplasty 

An angioplasty procedure opens up the blocked artery by using a balloon attached to a catheter or by removing a plaque buildup. 

Stent Placement 

A stent is a wire mesh tube that is inserted into the artery to keep it open after an angioplasty procedure. 

Heart Bypass Surgery 

In a heart bypass surgery, a doctor will reroute your blood flow around the blockage to restore heart function. 

Heart Valve Surgery 

During heart valve surgery, leaky valves are replaced to aid the heart in pumping blood. 

Pacemaker Placement 

A pacemaker is implanted beneath the skin and is designed to help the heart maintain a normal rhythm. 

Heart Transplant 

A heart transplant may be performed in severe cases when the heart attack has caused permanent tissue death to the majority of the heart.

Treatment for Cardiac Arrest

Emergency treatment for sudden cardiac arrest includes cardiopulmonary resuscitation (CPR) using a defibrillator or chest compressions to maintain blood flow which provides oxygen to the body. Using a defibrillator will deliver an electrical shock to the heart which momentarily stops the heart and often facilitates the return of the normal heart rhythm.

Long-term treatment for cardiac arrest can include medications such as antiarrhythmic drugs known as beta blockers or angiotensin-converting enzyme (ACE) inhibitors and channel blockers intended to reduce the risk of cardiac arrest. 

A doctor may also insert an implantable cardioverter-defibrillator (ICD) which is a battery-powered unit placed into the body near the left collarbone. There are one or more electrode-tipped wires from the unit that run through veins to the heart to constantly monitor its rhythm. If the rhythm becomes too slow, the unit paces your heart as a pacemaker would. If it detects a dangerous rhythm change, it sends out a low or high energy shock to reset the heart to a normal rhythm. 

A coronary angioplasty procedure can open the blocked coronary arteries which allows blood to flow more freely to the heart. The procedure is intended to reduce risk of serious arrhythmia. It involves a thin tube being passed through an artery (usually in the leg) all the way to the blocked artery in the heart. A catheter equipped with a special balloon tip briefly inflates to open the blocked artery. At the same time, a metal mesh stent may be inserted into the artery to keep it open long-term to restore blood flow to the heart. This procedure can be done at the same time as coronary catheterization. 

Cardiac bypass surgery is a procedure that involves coronary artery bypass grafting. This means that veins or arteries are sewed away from the blocked or narrowed heart artery which restores blood flow to the heart and reduces the frequency of racing heartbeats. 

Radiofrequency catheter ablation is also an option which is used to block a single abnormal electrical pathway. One or more catheters is moved through the blood vessels to the heart and is positioned along the electrical pathways that are causing the abnormal heart rate. The electrodes on the catheter tips are heated with radiofrequency energy to heat the tissue at the site of the arrhythmia in order to destroy it. 

Corrective heart surgery is also an alternative if a patient has a congenital heart deformity, a faulty heart valve, or diseased muscle tissue due to cardiomyopathy. The surgery to correct the abnormality can improve heart rate and blood flow which reduces risk of abnormal heart rates. 

Treatment for Acute Coronary Syndrome

Treatment usually involves medications and an angioplasty procedure. The procedure involves doctors inflating a small balloon attached to a catheter to open the blocked artery. A stent (wire mesh tube) may be permanently placed in the formerly blocked artery to keep it open. A coronary bypass surgery may also be used to reroute the blood flow. The surgeon takes a piece of blood vessel (graft) from another part of the body to create a new route for the blood to flow around the blocked artery. 

Medications are also used to dissolve blood clots. These medications include thrombolytics (clot busters) which dissolve a blood clot by temporarily widening blood vessels, antiplatelet drugs to prevent future blood clots from forming, beta blockers to relax the heart muscle and slow the heart rate, angiotensin-converting enzyme (ACE) inhibitors to widen blood vessels and improve blood flow, and angiotensin receptor blockers (ARBs) to help control blood pressure. 

Treatment for Aortic Dissection

Aortic dissection can be treated by medication, surgery, and other endovascular treatments. Depending on how much of the aorta is torn, repair may require open heart surgery which involves replacing the aorta with a fabric tube called a graft. Surgeons can also use stent grafts (fabric tube supported by metal wire stents) to repair the existing aorta. Stent grafts are placed into the patient endovascularly which means they are placed over a wire through a small incision in the groin, delivered upstream into the aorta, and then release stents like a spring. There are also hybrid procedures that combine open heart surgery with endovascular stent grafting techniques. Additionally, medications such as beta blockers are prescribed to lower a patient’s heart rate and blood pressure. 

For Type A aortic dissection, surgeons remove as much of the dissected aorta as possible, block the blood from entering the aortic wall, and then reconstruct the aorta with a graft. Leaking aortic valves can also be replaced at this time. 

For Type B aortic dissection, surgeons use similar techniques to those used to treat Type A, but they may also involve stents to act as scaffolding in the aorta to hold up the repairs. 

After all types of aortic dissection treatments, patients will likely need to take medications to lower their blood pressure for the remainder of their lives. 

For more information about MACE injuries connected to Xeljanz, read our Xeljanz Injuries: Major Adverse Cardiac Events blog. 

Treatment for Strokes

Treatment for ischemic strokes focuses on restoring blood flow to the brain. It usually begins with taking drugs to break down blood clots and prevent others from forming. Medical professionals may administer blood thinners such as aspirin or inject a tissue plasminogen activator (TPA). An emergency procedure may include administering a TPA directly into an artery in the brain or using a catheter to physically remove the blood clot. 

Other procedures include a carotid endarterectomy which involves opening the carotid artery and removing the plaque that could break off and travel to the brain. Another procedure is an angioplasty in which a surgeon inflates a small balloon inside the narrowed artery using a catheter. Then a mesh tube (stent) is inserted into the opening to prevent the artery from narrowing again. 

Treatment for a hemorrhagic stroke involves controlling the bleeding and reducing pressure on the brain. It usually starts with taking medication to reduce the pressure and control the overall blood pressure. The treatment is also aimed at preventing seizures and any sudden constrictions of blood vessels. 

If a patient is taking blood-thinning medications such as anticoagulants or antiplatelets, they can receive medications to counter the effects of the blood thinners to decrease the bleeding. 

Otherwise, surgeons can repair the bulge in the blood vessel that burst (aneurysm) by placing small clamps at the base of the aneurysm or fill it with detachable coils to stop the blood flow and shrink the aneurysm.

If a patient has had an ischemic stroke or a TIA, the doctor may recommend preventative medications such as antiplatelet and anticoagulant drugs. Antiplatelet drugs make the platelet cells in the blood less sticky and less likely to clot. The most common antiplatelet drug is aspirin. Anticoagulant medications are given to reduce blood clotting. 

Rehabilitation treatment for strokes includes speech therapy, physical therapy, occupational therapy, support groups, and psychological treatment. Speech therapy helps patients with difficulties speaking or understanding speech by practicing, relaxing the patient, and changing their communication style to make the process easier. Physical therapy helps a person relearn movements and coordination in addition to staying active.  Occupational therapy helps patients carry out daily activities such as bathing, cooking, dressing, eating, reading, and writing. Support groups and psychological treatment help patients deal with the mental health issues that can occur after a stroke–such as depression–through counseling and/or antidepressant medications.

Treatment for Blood Clots

Treatment for blood clots range from medication to surgery. Medications can include blood thinning medications such as anticoagulants. These medications stop the blood clots from growing and allow the body to break down the blood clots naturally. 

Surgical procedures to remove blood clots include catheter-directed thrombolysis procedures. These procedures involve a specialist directing a long tube (a catheter) to the blood clot. The catheter delivers the medication directly to the blood clot to help it dissolve. In thrombectomy surgeries, doctors use special instruments to carefully remove the blood clot and may insert a stent to keep the blood vessel, artery, or vein open. If a patient is unable to take blood thinners, a filter may be put into the inferior vena cava (the body’s largest vein) to catch blood clots before they can travel to internal organs. 

Compression stockings are also used as treatment. The tight-fitting socks apply pressure to help reduce leg swelling and prevent more blood clots from forming. 

Treatment depends on where the clot formed in the body, how much damage the blood clot could cause, and how dangerous it would be to remove the blood clot. 

The goal in treating blood clots (especially those formed with DVTs) is to prevent blood clots from getting larger or breaking loose. Effective treatment can reduce an individual’s chances of developing more blood clots in the future. 

For more information about increased risk of blood clots and strokes connected to Xeljanz, read our Xeljanz Stroke and Blood Clot Injuries blog.

How GoldenbergLaw Can Help

If you or a loved one have been injured after taking Xeljanz, contact the Dangerous Drug Attorneys at GoldenbergLaw. Our team has over thirty years of experience providing the Gold standard of advocacy. Leave the sleepless nights to us!

Xeljanz Injuries: Major Adverse Cardiac Events

Xeljanz and MACE Injuries

Preliminary results from an FDA-mandated study conducted by Xeljanz and Xeljanz XR’s manufacturer, Pfizer, found that patients taking the popular rheumatoid arthritis medication are at an increased risk of developing serious heart-related injuries. 

Xeljanz is also used to treat psoriatic arthritis and ulcerative colitis. The preliminary results of the study were concerning enough to spur the FDA to issue a safety communication warning consumers about an increased risk of major adverse cardiac events (MACE), blood clots, and cancer in patients taking Xeljanz.

What Are MACE Injuries?

Major Adverse Cardiac Events (MACE) injuries include: 

  • Heart attack (myocardial infarction) 
  • Cardiac arrest
  • Acute coronary syndrome 
  • Aortic dissection

What Is a Heart Attack (Myocardial Infarction)?

A heart attack occurs when the flow of blood to the heart is blocked. The blockage is usually caused by a buildup of fat, cholesterol, other substances. The substances form a plaque in the arteries that feed blood to the heart (coronary arteries). If the plaque ruptures, a clot can be formed that blocks blood flow to the heart. If blood flow is interrupted, damage or destruction of parts of the heart muscle can occur. The technical term for a heart attack is myocardial infarction.

Heart attacks can be fatal, so it is important to call 911 for emergency medical help if you or a loved one experiences heart attack symptoms. Heart attack symptoms include: 

  • Pressure, tightness, pain, or squeezing or aching sensation in chest or arms that may spread to neck, jaw or back 
  • Nausea, indigestion, heartburn or abdominal pain 
  • Cold sweat
  • Fatigue 
  • Lightheadedness or sudden dizziness

What Can Happen If I Suffer a Heart Attack?

According to the Centers for Disease Control and Prevention, the more time that passes after a heart attack without treatment to restore blood flow, the greater the damage to the heart. 

Complications from heart attacks are related to the damage caused to the heart muscle during the myocardial infarction. Abnormal heart rhythms (arrhythmias) can occur which are electric “short circuits” that can be serious and may lead to death. If the heart attack damages a substantial amount of heart tissue causing the heart muscle to be unable to pump enough blood out of the heart, heart failure can occur. It can be a temporary or chronic conduct. Sudden cardiac arrest can occur without warning. It involves your heart stopping due to an electrical disturbance causing an abnormal heart rhythm. Heart attacks increase the risk of sudden cardiac risk, which can be fatal without immediate treatment.

What Is Cardiac Arrest?

Sudden cardiac arrest is the abrupt loss of heart function, breathing, and consciousness. The condition is usually caused by problems with the heart’s electrical system–usually an abnormal heart rhythm (arrhythmia). This disrupts the heart’s pumping mechanism and stops blood flow to the body. It is distinct from a heart attack which occurs when blood flow to part of the heart has been blocked. However, a heart attack can sometimes trigger an electrical disturbance leading to sudden cardiac arrest. If sudden cardiac arrest is not treated immediately, it can lead to death. 

Symptoms of Sudden Cardiac Arrest include: 

  • Sudden collapse 
  • No pulse 
  • No breathing 
  • Loss of consciousness 
  • Chest discomfort 
  • Shortness of breath 
  • Weakness
  • Fast-beating, fluttering or pounding heart (palpitations) 

What Can Happen If I Suffer Cardiac Arrest?

Complications of sudden cardiac arrest are reduced blood flow to the brain which can cause unconsciousness. If the heart rhythm does not quickly return to normal, brain damage and death may occur. Survivors of sudden cardiac arrest may have long-term brain damage.

What Is Acute Coronary Syndrome?

Acute coronary syndrome encompasses a range of conditions associated with the sudden reduction of blood flow to the heart. It is usually caused by the buildup of fatty deposits known as plaques in and on the walls of the arteries in the heart which deliver oxygen and nutrients to the heart muscles. When the plaque ruptures or splits, a blood clot forms which blocks the flow of blood. When the supply of oxygen becomes too low, heart cells can die. The death of cells which result in damage to muscle tissues in the heart is known as a heart attack. Even if the acute coronary syndrome does not cause cell death around the heart, reduced blood flow can change how the heart works and creates a higher risk of heart attacks. 

Symptoms of acute coronary syndrome include: 

  • Chest pain or discomfort 
  • Pain spreading from chest to shoulders, arms, upper abdomen, back, neck or jaw 
  • Nausea or vomiting 
  • Indigestion 
  • Shortness of breath 
  • Sudden, heavy sweating 
  • Lightheadedness, dizziness or fainting 
  • Unusual or unexplained fatigue 
  • Feeling restless or apprehensive

What Can Happen If I Suffer Acute Coronary Syndrome?

Acute coronary syndrome is a medical emergency requiring immediate treatment. Even with immediate treatment, temporary or long-term damage can occur.

What Is Aortic Dissection?

Aortic dissection is a serious condition where the inner layer of the large blood vessel that branches off from the heart (the aorta) tears. Then blood comes through the tear and causes the inner and middle layers of the aorta to separate (dissect). If there is a rupture outside the aortic wall, aortic dissection can be fatal. Chronic high blood pressure may stress aortic tissue which makes it more susceptible to tearing. 

There are two types of aortic dissection: Type A and Type B. Type A is the most common and dangerous type. It involves a tear in the part of the aorta where it exits the heart or occurs in the upper aorta which could extend into the abdomen. Type B involves a tear in the lower aorta which can also extend into the abdomen. 

Symptoms of aortic dissection include: 

  • Sudden severe chest or upper back pain that radiate to neck or down back 
  • Sudden severe abdominal pain 
  • Loss of consciousness
  • Shortness of breath 
  • Sudden difficulty speaking, loss of vision, weakness or paralysis of one side of your body, similar to those of a stroke
  • Weak pulse in one arm or thigh compared with other
  • Leg pain 
  • Difficulty walking 
  • Leg paralysis

What Can Happen If I Suffer Aortic Dissection?

Complications from aortic dissection include death from internal bleeding, organ damage such as kidney failure or intestinal damage, stroke, aortic valve damage (aortic regurgitation) or a rupture in the lining around the heart (cardiac tamponade).

How GoldenbergLaw Can Help

If you or a loved one suffered a heart-related injury after taking Xeljanz, contact the team of Xeljanz Attorneys at GoldenbergLaw today for a free consultation. We have over 35 years of defective pharmaceutical litigation experience, let us provide the Gold standard of advocacy you deserve.