Medication: Xeljanz (Tofacitinib)

Xeljanz is a medication prescribed for rheumatoid arthritis (RA).

About Rheumatoid Arthritis

Rheumatoid arthritis is a type of autoimmune disease where the body mistakenly attacks its own joints. About three times more women than men have this, and RA generally strikes between the ages of 30-60. Symptoms, or flares, can last from days to months. Joint stiffness, swollen joints, fatigue, and pain are signs of RA. There is no known cure, but there are many medications that can slow its progression, reduce the inflammation, and ease symptoms. Remission is the goal. Besides medications, there are self-care activities that patients should try, such as weight management, eating a healthy diet, and engaging in regular physical activity to keep the muscles strong so that they protect the joints.¹

What is Xeljanz?

Xeljanz (tofacitinib) is different from other rheumatoid arthritis (RA) prescriptions in that it is a “Janus-associated kinase (JAK) inhibitor”. It is meant to reduce swelling, stiffness, and joint pain by disrupting the “signaling of cytokines associated with the inflammation”. It may take up to six months to work, but some patients may have their pain and swelling reduced within weeks.² Xeljanz is also referred to as a DMARD, or “disease-modifying anti-rheumatic drug”. For patients who cannot take methotrexate, tofacitinib is an option. It can also be combined with methotrexate, but it should not be used with strong immunosuppressants or biologic drugs. Biologics for RA include Remicade, Enbrel, Orencia, and Humira, for example. Xeljanz is approved for 5mg doses, taken orally. Side-effects can include diarrhea, headache, nasopharyngitis, and upper respiratory infections. There are more serious infections that can result, such as fungal, viral, bacterial, and tuberculosis, that can lead to a hospital stay or even death. Patients taking Xeljanz may also have “lymphoma and other malignancies”, and the medication is not for people with liver disease.³ Live vaccines should not be taken while a patient is on Xeljanz. The risk of opportunistic infections increases when patients take tofacitinib. Pfizer is the manufacturer of the medication.⁴

Chiropractic

Chiropractors can treat patients with RA. The American Chiropractic Association recommends that chiropractic care be used to increase muscle tone and strength, improve endurance and flexibility, increase range of motion, and suggest supplements along with dietary advice so that inflammation can be reduced. Treatments can include specific types of manipulation (that are safe for patients with RA), ultrasound, electronic stimulation, magnet therapy, rehabilitative exercises, heat and ice, and massage.⁵