New Oral RA Med

Yesterday, the FDA approved Pfizer’s XELJANZ (tofacitinib) for treatment of RA when methotrexate has failed to work adequately.  This oral medicine is in a new class of drugs:  Janus kinase (JAK) inhibitor.

Another JAK, ruxolitinib, was approved last year for the treatment of myelofibrosis.  Other JAK inhibitors are being tested as treatments for psoriasis, RA, and some cancers.  I have to admit that reading about JAKs made my eyes glaze over; all I retained was “just another kinase” having to do with cytokine receptors and “named after the two-faced Roman god Janus.”   Perhaps Andrew will write something comprehensible for us laymen (hint).  Until then, I know which reading material I’ll select next time insomnia strikes.

Tofacitinab comes with the black-box warning that RA patients are all too familiar with:  elevated liver enzymes, lower blood counts, high cholesterol, and increased risk of infection, tuberculosis, lymphoma, and cancers.  Post-marketing studies were ordered, so time will tell how effective this medication is, and whether there are other side effects to watch for.  Those who have run the gauntlet of every available medicine but found no relief now have a new treatment option.

See Medscape’s article here, and the FDA’s approval letter here.

4 thoughts on “New Oral RA Med

  1. Thanks for the prompt! I’ve been thinking about revisiting kinase inhibitors for some time now. My rheumy mentioned tofacitinib (the new name Xeljanz just isn’t sticking with me) as a treatment possibility to add onto Orencia. But now I see that you can’t take a biological with it.

    • I thought you’d written something, and actually started looking but didn’t find it. Thank you for providing the link 🙂

      Not only isn’t it approved for use with a biologic, I saw something this morning hinting that it will be priced like a biologic 😦

  2. My reading indicates that the safety profile is somewhat worse than humira’s. The response rate is about the same. They are going to be pricing it in the same range as a biologic even though as a small molecule med is should be significantly cheaper to produce. (?!) You can’t take it with a biologic because of the immune suppresion but they did test with MTX.They don’t have any data yet on long term effect on joint damage.

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