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

Key takeaways

Xeljanz (tofacitinib) and Remicade (infliximab) are both used to treat inflammatory and autoimmune conditions, but they have some key differences. Xeljanz is a tablet that can be taken once or twice daily depending on formulation, while Remicade is given through an IV infusion every 6 to 8 weeks by a healthcare professional. Xeljanz is available in both immediate-release and extended-release tablets, as well as a liquid form, whereas Remicade does not have a generic form and is only available as an injection. Xeljanz can be used for conditions like rheumatoid arthritis and ulcerative colitis in both adults and children, while Remicade treats similar conditions but is also approved for Crohn's disease and severe plaque psoriasis. Xeljanz has a higher risk of serious side effects like heart problems and blood clots, while Remicade can cause severe infections and liver problems.

Xeljanz

(tofacitinib)

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Remicade

(infliximab)

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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 Remicade

Prescription only

Remicade (infliximab) is an injectable medication used to treat many autoimmune conditions, including ulcerative colitis and Crohn's disease. It's given through an intravenous (IV) infusion by a healthcare provider.

Indications for Remicade

Moderate-to-severe Crohn's disease (CD)
Moderate-to-severe ulcerative colitis (UC)
Moderate-to-severe rheumatoid arthritis (RA)
Ankylosing spondylitis (AS)
Psoriatic arthritis (PsA)
Severe plaque psoriasis (PsO)

Pros and Cons for Remicade

Pros

Can be used for many autoimmune conditions
Typically only needs to be given every 6 to 8 weeks
Can be used in children 6 years of age and older for UC and CD

Cons

Can only be given as an IV infusion by a healthcare professional
Can cause a lot of side effects
Brand name only, which can be expensive

Common Side Effects for Remicade

Infections
Nausea
Infusion-related reactions (e.g., headache, flushing, shortness of breath, rash)
Headache
Diarrhea
Stomach pain
Sore throat
Cough
Rash
Bronchitis
Indigestion
Tiredness
General pain
Joint pain