Mode
Text Size
Log in / Sign up

FDA approved Xeljanz (tofacitinib) for Pediatric Psoriatic Arthritis and Juvenile Idiopathic ArthritisFDA approved Xeljanz for children with arthritis conditions.

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider Xeljanz for pediatric PsA or pcJIA after TNF blocker failure, but avoid combining with biologics or potent immunosuppressants.

The FDA has approved Xeljanz (tofacitinib) for pediatric patients 2 years of age and older with active psoriatic arthritis (PsA) or polyarticular course juvenile idiopathic arthritis (pcJIA) who have had an inadequate response or intolerance to one or more TNF blockers. This approval adds to the existing indications for Xeljanz in adults with rheumatoid arthritis, PsA, ankylosing spondylitis, and ulcerative colitis. The pediatric approval provides a new oral treatment option for children with these inflammatory conditions, though the label notes that use in combination with biologic DMARDs or potent immunosuppressants such as azathioprine and cyclosporine is not recommended. Clinicians should consider the risks and benefits when prescribing for pediatric patients.

Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Mechanism of Action

XELJANZ (tofacitinib) is a Janus kinase (JAK) inhibitor. The exact mechanism is not fully described in the label.

Indication & Patient Population

XELJANZ (tablets and oral solution) is indicated for the treatment of pediatric patients 2 years of age and older with active PsA or active pcJIA who have had an inadequate response or intolerance to one or more TNF blockers. Limitations of Use: Use in combination with biologic DMARDs or potent immunosuppressants such as azathioprine and cyclosporine is not recommended.

Dosing & Administration

For pediatric patients 2 years and older with PsA or pcJIA who weigh at least 10 kg: XELJANZ (tablets or oral solution) 5 mg twice daily for those ≥40 kg or weight-based equivalent twice daily for those <40 kg. Prior to initiation, consider TB evaluation, viral hepatitis screening, complete blood count, and updating immunizations. Avoid initiation if absolute lymphocyte count <500 cells/mm3, ANC <1000 cells/mm3, or hemoglobin <9 g/dL.

Key Clinical Trial Data

Trial data not available in label.

Warnings & Contraindications

Not reported in label for pediatric indications specifically. Refer to full prescribing information for warnings including serious infections, malignancies, and thrombosis.

Place in Therapy

XELJANZ is indicated for pediatric patients with active PsA or pcJIA after inadequate response or intolerance to TNF blockers. It should not be used in combination with biologic DMARDs or potent immunosuppressants.

The U.S. Food and Drug Administration has approved Xeljanz (tofacitinib) for children ages 2 and older with active psoriatic arthritis or polyarticular course juvenile idiopathic arthritis. These are inflammatory conditions that cause joint pain and swelling. The approval is for children who have not responded well to or could not tolerate one or more TNF blockers, which are another type of medicine for these conditions.

Xeljanz is a pill taken by mouth. It was already approved for adults with several inflammatory diseases, including rheumatoid arthritis and ulcerative colitis. This new approval gives doctors an oral option for children who need treatment. It may be especially helpful for families looking for an alternative to injections or infusions.

The FDA notes that Xeljanz should not be used with certain other strong immune-suppressing medicines, such as biologic DMARDs, azathioprine, or cyclosporine. Like all medicines, Xeljanz has risks. The most common side effects include infections, headache, and diarrhea. Serious risks include serious infections, blood clots, and cancer.

If you are a parent or caregiver, talk to your child's doctor about whether Xeljanz might be an option. Your doctor can help you weigh the benefits and risks based on your child's specific health situation. This approval does not mean Xeljanz is right for every child, but it offers a new choice for those who need it.

What this means for you:
Xeljanz is a new oral option for children with certain arthritis conditions who need an alternative to other treatments.

Study Details

Study typeFda approval
PublishedSep 2020
View Original Abstract ↓
1 INDICATIONS AND USAGE XELJANZ (tablets and oral solution) and XELJANZ XR (extended-release tablets) are Janus kinase (JAK) inhibitors. XELJANZ tablets and XELJANZ XR are indicated for the treatment of adult patients with: • Moderately to severely active rheumatoid arthritis (RA), who have had an inadequate response or intolerance to one or more TNF blockers. • Active psoriatic arthritis (PsA), who have had an inadequate response or intolerance to one or more TNF blockers. • Active ankylosing spondylitis (AS), who have had an inadequate response or intolerance to one or more TNF blockers. • Moderately to severely active ulcerative colitis (UC), who have had an inadequate response or intolerance to one or more TNF blockers. XELJANZ (tablets and oral solution) are indicated for the treatment of pediatric patients 2 years of age and older with: • Active PsA, who have had an inadequate response or intolerance to one or more TNF blockers. • Active polyarticular course juvenile idiopathic arthritis (pcJIA), who have had an inadequate response or intolerance to one or more TNF blockers. Limitations of Use : • Use of XELJANZ/XELJANZ XR for RA, AS, PsA, or pcJIA in combination with biologic DMARDs or potent immunosuppressants such as azathioprine and cyclosporine is not recommended. ( 1.1 , 1.2 , 1.3 , 1.4 ) • Use of XELJANZ tablets and XELJANZ XR for UC in combination with biological therapies for UC or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended. ( 1.5 ) 1.1 Rheumatoid Arthritis XELJANZ tablets and XELJANZ XR (extended-release tablets) are indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis (RA), who have had an inadequate response or intolerance to one or more TNF blockers. Limitations of Use Use of XELJANZ tablets or XELJANZ XR in combination with biologic disease-modifying antirheumatic drugs (DMARDs) or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended. 1.2 Psoriatic Arthritis XELJANZ (tablets and oral solution) is indicated for the treatment of adult and pediatric patients 2 years of age and older with active psoriatic arthritis (PsA), who have had an inadequate response or intolerance to one or more TNF blockers. XELJANZ XR (extended-release tablets) is indicated for the treatment of adults with active PsA who have had an inadequate response or intolerance to one or more TNF blockers. Limitations of Use Use of XELJANZ or XELJANZ XR in combination with biologic DMARDs or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended. 1.3 Ankylosing Spondylitis XELJANZ tablets and XELJANZ XR (extended-release tablets) are indicated for the treatment of adult patients with active ankylosing spondylitis (AS), who have had an inadequate response or intolerance to one or more TNF blockers. Limitations of Use Use of XELJANZ tablets or XELJANZ XR in combination with biologic DMARDs or potent immunosuppressants such as azathioprine and cyclosporine is not recommended. 1.4 Polyarticular Course Juvenile Idiopathic Arthritis XELJANZ (tablets and oral solution) are indicated for the treatment of pediatric patients 2 years of age and older with of active polyarticular course juvenile idiopathic arthritis (pcJIA), who have had an inadequate response or intolerance to one or more TNF blockers. Limitations of Use Use of XELJANZ in combination with biologic DMARDs or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended. 1.5 Ulcerative Colitis XELJANZ tablets and XELJANZ XR (extended-release tablets) are indicated for the treatment of adult patients with moderately to severely active ulcerative colitis (UC), who have an inadequate response or intolerance to one or more TNF blockers. Limitations of Use Use of XELJANZ tablets or XELJANZ XR in combination with biological therapies for UC or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.