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Janet H., a wife and mother from Alabama, had many things to celebrate in her life — two beautiful children, a wonderful husband, her dog Falco, and a rewarding career. She was proud that even with all of this, she was able to achieve her personal goal of staying active. However, she was diagnosed with a chronic disease the week before her 40th birthday.
Janet enjoyed moderate exercise, so when she began to have persistent joint pain and swelling in her knees, she suspected it was from an old injury. After initial visits with an orthopedic specialist, she was referred to a rheumatologist who diagnosed her with moderate to severe rheumatoid arthritis (RA) — a chronic, autoimmune disease of the joints.[i]
“I remember thinking that if this is what 40 is like, I don’t know if I can handle 50,” she says. “I wasn’t sure how RA would affect my life.”
Unfortunately, this story is all too common, as RA impacts approximately 1.6 million adults in the United States.[ii],[iii] Many living with a chronic condition like RA can feel that their life is put on hold while trying to manage their symptoms, doctor’s appointments, and the daily demands of life. Working toward personal goals can be put on the backburner, but does it have to be?
With her rheumatologist, Janet was motivated to find a treatment plan that could help relieve her RA symptoms before being prescribed XELJANZ® (tofacitinib) 5 mg twice daily tablets, an oral medication for adults with moderate to severe RA in which methotrexate did not work well enough. Janet’s rheumatologist reviewed the potential side effects of XELJANZ and explained that it is taken twice daily and has a BOXED WARNING for serious infections and malignancies.
Within three to six months, Janet felt improvement in her RA symptoms and found herself thinking about ways to become more active. She spoke with her rheumatologist and, together, they came up with exercise goals including yoga classes, cycling, and walking her dog with her husband and children. She also says one of her biggest milestones was walking her daughter down the aisle and gaining a new son-in-law. Eventually, Janet even worked with her rheumatologist to switch to a once-a-day version of XELJANZ, called XELJANZ XR extended release tablets.
Here are some of Janet’s tips to help someone living with a chronic illness work toward their personal goals:
- Plan ahead: Living with a chronic condition can put a pause on spontaneity. Plan ahead when it comes to things like travel or big life events to allow ample time for adjustments and preparation.
- Partner up: Find a significant other, friend or sibling who can join you on your journey toward reaching your goals. Sometimes living with a chronic condition requires extra support from others, so having a partner to plan with can help make that support seamless.
- Consult your doctor: Before considering any new travel or physical activity, make sure to consult your doctor. Discuss your plans and how you and your doctor can work together to help ensure you can meet these goals.
By following these tips, Janet says that she has been able to better manage her RA and have more time to focus on her family, friends and herself.
“I hope my story can help other adults who are living with moderate to severe rheumatoid arthritis and inspire them to share their stories,” she says.
What is XELJANZ/XELJANZ XR?
XELJANZ/XELJANZ XR is a prescription medicine called a Janus kinase (JAK) inhibitor. XELJANZ/XELJANZ XR is used to treat adults with moderately to severely active rheumatoid arthritis in which methotrexate did not work well.
It is not known if XELJANZ/XELJANZ XR is safe and effective in people with hepatitis B or C.
XELJANZ/XELJANZ XR is not recommended for people with severe liver problems.
It is not known if XELJANZ/XELJANZ XR is safe and effective in children.
IMPORTANT SAFETY INFORMATION
What is the most important information I should know about XELJANZ/XELJANZ XR?
XELJANZ/XELJANZ XR may cause serious side effects, including:
Serious infections. XELJANZ/XELJANZ XR can lower the ability of your immune system to fight infections. Some people can have serious infections while taking XELJANZ/XELJANZ XR, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting and during XELJANZ/XELJANZ XR treatment, and monitor you closely for signs and symptoms of TB infection during treatment. You should not start taking XELJANZ/XELJANZ XR if you have any kind of infection unless your healthcare provider tells you it is okay.
You may be at a higher risk of developing shingles (herpes zoster).
Before starting XELJANZ/XELJANZ XR, tell your healthcare provider if you:
- think you have an infection or have symptoms of an infection, such as fever, sweating, or chills; cough; blood in phlegm; warm, red, or painful skin or sores on your body; burning when you urinate or urinating more often than normal; muscle aches; shortness of breath; weight loss; diarrhea or stomach pain; or feeling very tired
- are being treated for an infection
- get a lot of infections or have infections that keep coming back
- have diabetes, chronic lung disease, HIV, or a weak immune system. People with these conditions have a higher chance for infections
- have TB, or have been in close contact with someone with TB
- live or have lived in, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis). These infections may happen or become more severe if you use XELJANZ/XELJANZ XR. Ask your healthcare provider if you do not know if you have lived in an area where these infections are common
- have or have had hepatitis B or C
After starting XELJANZ/XELJANZ XR, call your healthcare provider right away if you have any symptoms of an infection. XELJANZ/XELJANZ XR can make you more likely to get infections or make worse any infection that you have.
Cancer and immune system problems. XELJANZ/XELJANZ XR may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers, including skin cancers, have happened in patients taking XELJANZ/XELJANZ XR. Tell your healthcare provider if you have ever had any type of cancer.
Some people who have taken XELJANZ with certain other medicines to prevent kidney transplant rejection have had a problem with certain white blood cells growing out of control (Epstein Barr Virus–associated post-transplant lymphoproliferative disorder).
Tears (perforation) in the stomach or intestines. Some people taking XELJANZ/XELJANZ XR can get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.
Tell your healthcare provider right away if you have fever and stomach-area pain that does not go away and a change in your bowel habits.
Changes in certain lab test results. Your healthcare provider should do blood tests before you start receiving XELJANZ/XELJANZ XR, and while you take XELJANZ/XELJANZ XR, to check for the following side effects:
- changes in lymphocyte counts. Lymphocytes are white blood cells that help the body fight off infections.
- low neutrophil counts. Neutrophils are white blood cells that help the body fight off infections.
- low red blood cell count. This may mean that you have anemia, which may make you feel weak and tired.
Your healthcare provider should routinely check certain liver tests.
You should not receive XELJANZ/XELJANZ XR if your lymphocyte count, neutrophil count, or red blood cell count is too low or your liver tests are too high. Your healthcare provider may stop your XELJANZ/XELJANZ XR treatment for a period of time if needed because of changes in these blood test results.
Your healthcare provider should do blood tests to check your cholesterol levels 4-8 weeks after you start XELJANZ/XELJANZ XR, and as needed after that.
What should I tell my healthcare provider before taking XELJANZ/XELJANZ XR?
Before taking XELJANZ/XELJANZ XR, tell your healthcare provider about all of your medical conditions, including if you:
- have an infection
- have liver problems
- have kidney problems
- have any stomach area (abdominal) pain or been diagnosed with diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines, or narrowing within your digestive tract
- have had a reaction to tofacitinib or any of the ingredients in XELJANZ/XELJANZ XR
- have recently received or are scheduled to receive a vaccine. People taking XELJANZ/XELJANZ XR should not receive live vaccines but can receive non-live vaccines
- plan to become pregnant or are pregnant. It is not known if XELJANZ/XELJANZ XR will harm an unborn baby. You should use effective birth control while you are taking XELJANZ/XELJANZ XR and for at least 4 weeks after you take your last dose.
- Pregnancy Registry: Pfizer has a registry for pregnant women who take XELJANZ/XELJANZ XR. The purpose of this registry is to check the health of the pregnant mother and her baby. If you are pregnant or become pregnant while taking XELJANZ/XELJANZ XR, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at 1-877-311-8972 to enroll
- plan to breastfeed or are breastfeeding
Tell your healthcare provider about all of the medicines you take, especially any other medicines to treat your rheumatoid arthritis. You should not take tocilizumab (Actemra®), etanercept (Enbrel®), adalimumab (Humira®), infliximab (Remicade®), rituximab (Rituxan®), abatacept (Orencia®), anakinra (Kineret®), certolizumab pegol (Cimzia®), golimumab (Simponi®), ustekinumab (Stelara®), secukinumab (Cosentyx®), azathioprine, cyclosporine, or other immunosuppressive drugs while you are taking XELJANZ/XELJANZ XR. Taking XELJANZ or XELJANZ XR with these medicines may increase your risk of infection.
- Tell your healthcare provider if you are taking medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
Taking XELJANZ/XELJANZ XR
When you take XELJANZ XR, you may see something in your stool that looks like a tablet. This is the empty shell from the tablet after the medicine has been absorbed by your body.
What are other possible side effects of XELJANZ/XELJANZ XR?
XELJANZ/XELJANZ XR may cause serious side effects, including hepatitis B or C activation infection in people who carry the virus in their blood. If you are a carrier of the hepatitis B or C virus (viruses that affect the liver), the virus may become active while you use XELJANZ/XELJANZ XR. Tell your healthcare provider if you have the following symptoms of a possible hepatitis B or C infection: feel very tired, little or no appetite, clay-colored bowel movements, chills, muscle aches, skin rash, skin or eyes look yellow, vomiting, fevers, stomach discomfort, or dark urine.
Common side effects of XELJANZ/XELJANZ XR include upper respiratory tract infections (common cold, sinus infections), headache, diarrhea, and nasal congestion, sore throat, and runny nose (nasopharyngitis).
To learn more about XELJANZ/XELJANZ XR, a treatment option for moderately to severely active RA, visit XELJANZ.com.
Please click the direct link to the full US Prescribing Information for XELJANZ/XELJANZ XR, including BOXED WARNING and Medication Guide: http://labeling.pfizer.com/ShowLabeling.aspx?id=959.
[i] National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). National Institutes of Health, Department of Health and Human Services. Handout on health: rheumatoid arthritis. August 2014. http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp. Accessed December 4, 2017.
[ii] Sacks J, Lou Y, Helmick, C. Prevalence of specific types of arthritis and other rheumatic conditions in the ambulatory health care system in the United States 2001-2005. Arthritis Care Res. 2010;62(4):460-464.
[iii] Howden L, Meyer J. 2010 U.S. Census Bureau results — U.S. Census Bureau, 2010 Census Summary File 1.