III. Mechanism

  1. Interferes with Cytokine signalling on receptor binding

IV. Preparations

  1. Ruxolitinib or Jakafi (JAK1 and JAK2 Inhibitor)
    1. Indicated in Rheumatoid Arthritis and Myelofibrosis (including Polycythemia Vera)
  2. Baricitinib or Olumiant (JAK1 and JAK2 inhibitor)
    1. Indicated in Rheumatoid Arthritis
  3. Upadacitinib or Rinvoq (JAK1 inhibitor)
    1. Indicated in Rheumatoid Arthritis
  4. Tofacitinib or Xeljanz (JAK3 Inhibitor)
    1. Indicated in Rheumatoid Arthritis and Psoriasis
    2. Multiple black box warnings
      1. Serious infections
      2. Thrombosis (e.g. Venous Thromboembolism)
      3. Cardiovascular events (e.g. Myocardial Infarction)
      4. Lung Cancer
      5. Increased mortality
    3. References
      1. (2021) Presc Lett 28(4): 22

V. Adverse Effects

  1. Venous Thromboembolism
  2. Sudden cardiovascular death (associated with Tofacitinib)
  3. Immunosuppression
    1. Tuberculosis reactivation risk
    2. Increased risk of Pneumonia, Shingles

VI. Precautions

  1. Avoid Live Vaccines

VII. References

  1. (2019) Presc Lett 26(10): 58

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Cost: Medications

xeljanz (on 1/1/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
XELJANZ 5 MG TABLET $89.28 each
XELJANZ XR 11 MG TABLET $178.55 each
rinvoq (on 1/14/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
RINVOQ ER 15 MG TABLET $183.59 each