Xeljanz vs. Humira for Rheumatoid Arthritis: Important Differences and Potential Risks.

Key takeaways

Xeljanz (tofacitinib) and Humira (adalimumab) are both used to treat inflammatory conditions, but they have some key differences. Xeljanz is a tablet taken once or twice daily, while Humira is given as an injection every few weeks depending on your condition. Xeljanz is synthetic and not considered a biologic, whereas Humira is made from living sources. Xeljanz can be used for conditions like rheumatoid arthritis and ulcerative colitis in both adults and children, but it has serious risks like heart problems and blood clots. Both medications can be used in children, but Humira treats a wider range of conditions, including Crohn's disease and plaque psoriasis. Both medications carry a risk of increased infections, but Humira can’t be used with live vaccines.

Xeljanz

(tofacitinib)

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Humira

(adalimumab)

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Summary for Xeljanz

Prescription only

Xeljanz (tofacitinib) is an oral medication that can treat different inflammatory problems. It can help adults with psoriatic arthritis, rheumatoid arthritis (RA), and ulcerative colitis, among other conditions. It's also helpful for children with a certain kind of arthritis. Xeljanz (tofacitinib) is a JAK inhibitor that lowers inflammation in the body. It comes as a tablet or liquid that's taken twice a day. There's also a longer-lasting once-daily tablet for adults. Xeljanz (tofacitinib) is a good option for people who've tried other medications first. But it can have side effects like headache, diarrhea, and a higher risk of infection. This medication is brand name only; there isn't a generic yet.

Indications for Xeljanz

Moderate-to-severe rheumatoid arthritis (RA) in adults
Psoriatic arthritis (PsA) in adults
Ankylosing spondylitis (AS) in adults
Moderate-to-severe ulcerative colitis (UC) in adults
Moderate-to-severe polyarticular course juvenile idiopathic arthritis (pcJIA) in children 2 years and older - immediate-release tablets and liquid only

Pros and Cons for Xeljanz

Pros

Liquid form available for the immediate-release version if you have trouble swallowing pills whole
Extended-release, once-daily tablets available for adults
Good option for people when other treatments haven't worked well

Cons

Has potentially serious risks (e.g., serious infections, blood clots)
Can raise cholesterol levels
Not clear if it's safe to take during pregnancy
Breastfeeding not recommended during treatment

Common Side Effects for Xeljanz

Arthritis:

Upper respiratory tract infection (4%)
Nose and throat infection (3-4%)
Diarrhea (3-4%)
Headache (3-4%)

Ulcerative colitis:

Nose and throat infection (10-14%)
High cholesterol (5-9%)
Headache (3-9%)
Upper respiratory tract infection (6-7%)
Lab results suggesting muscle damage (3-7%)
Rash (3-6%)
Diarrhea (2-5%)
Stomach infection (3-4%)
Anemia (2-4%)

Warnings for Xeljanz

Risk of serious infections
Possible higher risk of death for some older people with rheumatoid arthritis
Possible risk of cancer
Risk of blood clots, heart attack, or stroke
Stomach problems
Allergic reactions
Low blood cell counts
Liver damage

Summary for Humira

Prescription only

Humira (adalimumab) is an injection used to treat many different autoimmune conditions like rheumatoid arthritis, Crohn's disease, ulcerative colitis, and plaque psoriasis. As a TNF blocker, the medication works by blocking a protein that causes inflammation in your body. It's given as a shot under the skin once every 1 to 2 weeks, depending on your condition. Humira (adalimumab) doesn't have a true generic, but there are several similar versions called biosimilars. Common side effects include infections, injection site reactions, and headache.

Indications for Humira

Rheumatoid arthritis (RA) - adults only
Juvenile idiopathic arthritis (JIA) - people age 2 and older
Psoriatic arthritis (PsA) - adults only
Ankylosing spondylitis (AS) - adults only
Crohn's disease (CD) - people age 6 and older
Ulcerative colitis (UC) - people age 5 and older
Plaque psoriasis - adults only
Hidradenitis suppurativa (HS) - people age 12 and older
Uveitis - people age 2 and older

Pros and Cons for Humira

Pros

Can be used for many autoimmune conditions
Available as a ready-to-use pen that makes it easier to self-inject at home
Can be used in young children (as young as 2 years old for some conditions)
Only needs to be injected a couple times a month
Can be left at room temperature for up to 14 days if needed

Cons

Raises the risk of serious infections
Can take a few weeks or longer to work
Might be difficult to inject for some people
Can't receive any live vaccines while taking the medication
Might contain rubber or latex, which can cause a reaction for those with an allergy

Common Side Effects for Humira

Injection-site reaction (20%)
Upper respiratory tract infection (17%)
Headache (12%)
Rash (12%)
Sinus inflammation (11%)
Accidental injury (10%)
Nausea (9%)
Urinary tract infection (UTI) or bladder infection (8%)

Note: The side effects listed above were reported by adults with rheumatoid arthritis and are similar to those seen in people using Humira (adalimumab) for other conditions.