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Compare Xeljanz vs. Otezla

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Xeljanz (tofacitinib) and Otezla (apremilast) are both oral medications used to treat inflammatory conditions, but they belong to different drug classes and have distinct uses and side effects. Xeljanz is a Janus kinase (JAK) inhibitor that treats various types of arthritis and ulcerative colitis by blocking a protein involved in inflammation. In contrast, Otezla is a phosphodiesterase-4 (PDE-4) inhibitor that blocks a different protein to reduce inflammation associated with psoriatic arthritis, plaque psoriasis, and mouth sores from Behçet’s disease. Xeljanz can cause serious side effects like infections, heart problems, and blood clots, while Otezla is more likely to cause nausea, diarrhea, and weight loss. Both medications are not yet available as lower-cost generics. Xeljanz is available in both immediate-release and extended-release forms. And Otezla is only available in one formulation that requires a gradual dose increase to minimize stomach-related side effects.

Xeljanz (tofacitinib)
Otezla (apremilast)
Xeljanz (tofacitinib)
Otezla (apremilast)
Summary of Xeljanz vs. Otezla
Summary for JAK inhibitor
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.
Summary for PDE-4 inhibitor
Prescription only
Otezla (apremilast) is a tablet that's taken by mouth. It's used to treat plaque psoriasis, psoriatic arthritis, and mouth sores from Behçet’s disease. This medication belongs to the drug class called phosphodiesterase-4 (PDE-4) inhibitors. You usually start Otezla (apremilast) at a low dose. Then, the dose is slowly raised over 5 days to lower the risk of side effects like nausea and diarrhea. This medication is available as a brand-name medication. Generic versions of apremilast likely won't be available until at least 2028.
Indications of Xeljanz vs. Otezla
Indications for

•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

Indications for

•Active psoriatic arthritis in adults

•Moderate-to-severe plaque psoriasis in people age 6 years and older weighing at least 44 lbs

•Mouth sores from Behçet’s disease in adults
Pros and Cons of Xeljanz vs. Otezla
Pros and Const for JAK inhibitor
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

Pros and Const for PDE-4 inhibitor
Pros

•Taken by mouth

•Can take with or without food

•Dose adjustment available for people with severe kidney problems

Cons

•Dosing schedule can be confusing in the beginning

•Common to have nausea or diarrhea in the beginning

•Might not be a good option for people who've had depression or suicidal behavior
Common Side Effects of Xeljanz vs. Otezla
Common Side Effects for
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%)

Common Side Effects for

•Diarrhea (17%)

•Nausea (17%)

•Upper respiratory tract infection (e.g., common cold; 9%)

•Headache (6%)
Warnings of Xeljanz vs. Otezla
Common Side Effects for

•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

Common Side Effects for

•Allergic reaction

•Diarrhea, nausea, and vomiting

•Depression

•Possible weight loss

•Drug interactions
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Compare Xeljanz vs. Otezla

Key takeaways

Summary of Xeljanz vs. Otezla

Indications of Xeljanz vs. Otezla

Pros and Cons of Xeljanz vs. Otezla

Common Side Effects of Xeljanz vs. Otezla

Warnings of Xeljanz vs. Otezla

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