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 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!

Rehabilitative Care After Penumbra JET 7 Xtra Flex Catheter Injury

One of the most serious complications of a Penumbra JET 7 Xtra Flex catheter malfunction is a hemorrhagic stroke–commonly known as a brain bleed. A brain bleed occurs when blood begins bleeding into the brain, usually as the result of a weakened blood vessel rupturing. The bleeding creates pressure in the brain which can damage brain cells and result in diminished or complete loss of function in the impacted area of the brain. 

A hemorrhagic stroke is one of the injuries linked to the Penumbra Jet 7 Xtra Flex Catheter. The primary defect of the Penumbra Jet 7 is that the distal tip of the catheter can expand or balloon while inside a blood vessel. If the catheter balloons during a procedure it can become multiple times the size of the blood vessel and cause the blood vessel to burst. The bursting of the blood vessel may cause a hemorrhagic stroke to occur. 

Emergency Treatment of Hemorrhagic Strokes

The goal of emergency treatments for hemorrhagic strokes is to control the bleeding and reduce the pressure on the brain caused by the extra blood. Emergency treatments include

  • Drugs or transfusions to counteract effects of any blood-thinning medications a patient may be taking to prevent blood clots, reduce the pressure on the brain, lower blood pressure, prevent blood vessel spasms, and reduce the probability of seizures;
  • Surgical removal of the blood and reduction of pressure on the brain; 
  • Surgical clipping to place a clamp at the base of aneurysm to stop the blood flow; 
  • Endovascular embolization utilizing a catheter inserted into an artery in the patient’s groin, guided to the brain, and used to place tiny detachable coils into the aneurysm to block the blood flow and make the blood clot; 
  • Surgical AVM (arteriovenous malformation) removal to close an abnormal connection between blood vessels in order to prevent bleeding and rupture; and
  • Stereotactic radiosurgery using multiple beams of radiation to repair blood vessel malformations in a minimally invasive way. 

Penumbra JET 7 Xtra Flex Catheter Resource Center

What Happens After a Hemorrhagic Stroke?

Devastatingly, hemorrhagic strokes have a 51% to 65% mortality rate depending on the location of the bleeding in the brain. Of the patients who do survive the stroke, only 20% are expected to be independent within six months.  The journey to recovery of any sort from a hemorrhagic stroke is long and arduous. 

According to the National Stroke Association, 10% of people who have a stroke recover completely, and 25% recover with minor impairments. Almost 40% of people who have a stroke experience moderate to severe impairments which require special treatment to regain daily function at work or in personal life. Approximately 10% of patients require long-term care in a nursing home or other similar facility.

Rehabilitative Care After a Hemorrhagic Stroke

Stroke care focuses on helping patients regain as much function as possible in order to eventually return to living as independently as possible. However, it can be difficult to determine early on the amount of stroke care required since the impact of the stroke is determined by the area of the brain involved and the amount of tissue that was damaged. 

If the right side of the brain is harmed, movement and sensation on the left side of the body may be impacted. If the stroke damages the left side of the brain, movement and sensation on the right side of the body may be affected. Harm to the left side of the brain may also result in speech and language disorders. 

Rehabilitation occurs both at the hospital and once a patient is discharged. After discharge, rehabilitation will continue at one of the following locations: 

  • Rehabilitation unit in the same hospital 
  • Skilled nursing home separate from the hospital 
  • Patient’s home

Members of a patient’s stroke care team may include

  • Doctor trained in brain conditions (neurologist)
  • Rehabilitation doctor (physiatrist)
  • Rehabilitation nurse
  • Dietitian 
  • Physical therapist 
  • Occupational therapist 
  • Recreational therapist 
  • Speech pathologist 
  • Social worker or case manager
  • Psychologist or psychiatrist 
  • Chaplain 

Skill Recovery After Hemorrhagic Stroke

Strokes are considered to be a leading cause of serious long-term disability due to the probability of causing significant impairment in language, cognition, motor, and sensory skills. The goal of stroke rehabilitation is to improve skills that were lost as a result of the stroke. 

A stroke can cause a language impairment known as aphasia which creates general difficulty with speaking such as struggling to find the right words and challenges in speaking in full sentences. These issues can occur if the muscles that control speech were damaged in the stroke. Speech and language therapists can help to improve speech and language skills. If the damage is too severe to improve speaking skills, therapists can assist in developing other ways of communicating. 

Strokes can also inhibit thinking and reasoning abilities, lead to poor judgment, and cause memory and behavioral problems. Occupational therapists and speech and language therapists can assist in recovering these skills and help ensure that the patient’s home is a safe environment. 

A stroke can weaken the muscles on one side of the body and restrict joint movement. This results in decreased coordination and often makes walking difficult or leads to muscle spasms. Physical therapists can help patients learn how to balance and strengthen muscles again. 

Additionally, decreased sensory skills caused by strokes can decrease the body’s ability to feel sensory inputs such as heat, cold, or pressure.  Therapists can work to help patients adjust to these changes as well. 

Other complications that may also need to be treated include loss of bladder and bowel control, difficulty swallowing, and depression. 

GoldenbergLaw Can Help

If you or a loved one suffered a hemorrhagic stroke from a procedure where a Penumbra JET 7 Xtra Flex catheter was used, contact the Stroke and Brain Bleed Attorneys at GoldenbergLaw today for a free consultation. With over thirty years of experience, we will help you get the justice you deserve.