Understanding Psoriatic Arthritis
Did you know approximately 329,000 adults in the U.S. have psoriatic arthritis? Although psoriatic arthritis may be unpredictable, recognizing its symptoms can help you better understand your condition. To help you have a more informed conversation about treatment with your doctor, here are a few quick facts about psoriatic arthritis.
Up to 30% of patients with psoriasis will develop psoriatic arthritis
Dactylitis is reported in 40% to 50% of patients with psoriatic arthritis
Inflammation of the fingers or toes that may reduce mobility and cause tenderness
Enthesitis is seen in 30% to 50% of patients with psoriatic arthritis
Inflammation where ligaments and tendons insert into bone
What Is Psoriatic Arthritis?
Psoriatic arthritis is an immune-mediated disease. An immune-mediated disease is a chronic inflammatory condition caused by an abnormal response of the body’s immune system. It occurs in different parts of the body and may lead to multiple symptoms, such as joint inflammation and damage, and skin lesions, which can develop together or separately over time.
Psoriatic Arthritis Treatment Types
There are a number of ways to treat active psoriatic arthritis. And while there’s no cure for it, medication may help reduce the signs and symptoms of psoriatic arthritis.
Here are examples of some treatment types for active psoriatic arthritis.
Corticosteroids, also known as steroids, are used on a short-term basis to help with inflammation.
How they are prescribed: Pill or an injection into a muscle or directly into an affected joint
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to help with joint pain and inflammation.
How they are prescribed: Pill
Disease-modifying antirheumatic drugs (DMARDs) work to reduce the body's overactive immune and/or inflammatory processes that cause psoriatic arthritis symptoms such as joint pain and swelling.
The DMARD family can be classified as the following:
Traditional nonbiologic DMARDs, like methotrexate, are often prescribed at the time of diagnosis. Oral synthetic small molecules are another class of nonbiologic DMARDs.
One of the options available includes the Janus kinase (JAK) inhibitors. JAK inhibitors work by blocking JAK enzymes located within cells.
How they are prescribed: Injection
XELJANZ/XELJANZ XR is a JAK inhibitor and available as an oral pill.
Types of biologic DMARDs include tumor necrosis factor inhibitors (TNFis) and non-TNFis.
How they are prescribed: Injection or infusion
The joining together of different genetic materials in laboratories to make proteins that can be used as drugs
While surgery is not for everyone, it may be an option for people with severe joint damage that limits joint function.
Different Factors, Different Treatment Plans
A disease management plan should combine medications with other approaches. Because psoriatic arthritis is a progressive disease, different treatment options may be appropriate at different stages. It is important to start treatment soon after diagnosis.
When talking with your healthcare provider about treatment options, it’s important to remember that psoriatic arthritis affects everyone differently and the choice of therapy depends on a number of factors, including the severity of your condition.
Before starting treatment, discuss the benefits and risks of each type of therapy with your doctor. Certain screening tests, including blood tests for past exposure to certain infections, may be needed before starting some of these medications.
Before starting treatment, tell your doctor about your medical history. Tell your doctor if you have had an infection, such as TB, Hepatitis B or C, liver and kidney problems, or if you have a history of blood clots.
Talking To Your Doctor
If your current treatment is not working well enough to manage your psoriatic arthritis symptoms, it's important to speak up. Taking note of how your disease affects your daily life can help you prepare for a productive conversation with your doctor. Use our symptom tracker to get started.Start Tracking
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XELJANZ/XELJANZ XR (tofacitinib) is used to treat adults with:
- Moderately to severely active rheumatoid arthritis in whom methotrexate did not work well or cannot be tolerated
- Active psoriatic arthritis in which methotrexate or other similar medicines called nonbiologic disease-modifying antirheumatic drugs (DMARDs) did not work well or cannot be tolerated
- Moderately to severely active ulcerative colitis when medicines called tumor necrosis factor (TNF) blockers did not work well or cannot be tolerated
XELJANZ/XELJANZ Oral Solution is used to treat patients 2 years of age and older with active polyarticular juvenile arthritis.
It is not known if XELJANZ/XELJANZ XR is safe and effective in people with Hepatitis B or C.
XELJANZ/XELJANZ XR/XELJANZ Oral Solution is not recommended for people with severe liver problems.
It is not known if XELJANZ/XELJANZ Oral Solution is safe and effective in children for treatment other than active polyarticular juvenile arthritis.
It is not known if XELJANZ XR is safe and effective in children.
Important Safety Information
The safety information below applies to all marketed formulations of XELJANZ. Specific risks associated with certain dosing is noted.
Serious Infections. XELJANZ can lower the ability of your immune system to fight infections. Do not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay. Serious Infections have happened in people taking XELJANZ. These serious infections include 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 treatment with XELJANZ.
Before and after starting XELJANZ, tell your doctor if you have an infection or symptoms of an infection, including:
- Fever, sweating, or chills
- Blood in phlegm
- Warm, red, or painful skin or sores on your body
- Burning when you urinate
- Urinating more often than normal
- Muscle aches
- Shortness of breath
- Weight loss
- Diarrhea or stomach pain
- Feeling very tired
Increased risk of death in people 50 years of age and older with rheumatoid arthritis who have at least 1 heart disease (cardiovascular) risk factor and who are taking a higher than recommended dose of XELJANZ/XELJANZ XR. The recommended dose in patients with rheumatoid arthritis and psoriatic arthritis is XELJANZ 5 mg twice daily or XELJANZ XR 11 mg one time each day.
Cancer. 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, can happen. Tell your healthcare provider if you have ever had any type of cancer.
Higher dose. People taking the higher dose of XELJANZ (10 mg twice daily) or XELJANZ XR (22 mg one time each day) have a higher risk of serious infections, shingles, or skin cancers.
Immune System Problem. 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).
Blood clots in the lungs (pulmonary embolism, PE), veins of the legs (deep vein thrombosis, DVT) and arteries (arterial thrombosis) have happened more often in patients with rheumatoid arthritis who are 50 years of age and older and with at least 1 heart disease (cardiovascular) risk factor taking a higher than recommended dose of XELJANZ/XELJANZ XR. Blood clots in the lungs have also happened in patients with ulcerative colitis. Some people have died from these blood clots.
• Stop taking XELJANZ and tell your healthcare provider right away if you have any signs and symptoms of blood clots such as sudden shortness of breath, difficulty breathing, chest pain, swelling of a leg or arm, leg pain or tenderness, or red or discolored skin in the leg or arm.
Tears (perforation) in the stomach or intestines. Tell your healthcare provider if you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking XELJANZ 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, stomach-area pain that does not go away, and a change in your bowel habits.
Serious allergic reactions can occur. Stop using XELJANZ and call your healthcare provider right away if you have swelling of your lips, tongue, throat, or get hives.
Changes in certain lab test results. Your doctor should do blood tests to check your white and red blood cells before and while you are taking XELJANZ. Your doctor should also check certain liver tests. You should not receive XELJANZ if your lymphocyte count, neutrophil count, or red blood cell count is too low or your liver function test levels are too high. Changes in lab test results may cause your healthcare provider to stop your XELJANZ treatment for a time. Your cholesterol levels should be checked 4 to 8 weeks after you start receiving XELJANZ.
Before you use XELJANZ, tell your healthcare provider if you:
- Are being treated for an infection, have an infection that won’t go away or keeps coming back, or think you have symptoms of an infection
- Have TB, or have been in close contact with someone with TB, or were born in, lived in, or traveled where there is more risk for getting TB
- Have diabetes, chronic lung disease, HIV, or a weak immune system. People with these conditions have a higher chance for infections
- Live or have lived in certain areas (such as Ohio and Mississippi River Valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections
- Have or have had Hepatitis B or C
- Have had blood clots
- Have liver or kidney problems
- Have any stomach area (abdominal) pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines
- Have recently received or plan to receive a vaccine. People taking XELJANZ should not receive live vaccines but can receive non-live vaccines
- Are pregnant, planning to become pregnant, breastfeeding or planning to breastfeed. You should not take XELJANZ and breastfeed
- Have had a reaction to tofacitinib or any of the ingredients
- Are taking other medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take any of the following medicines while taking XELJANZ since this may increase your risk of infection:
- tocilizumab (Actemra®)
- etanercept (Enbrel®)
- adalimumab (Humira®)
- infliximab (Remicade®)
- rituximab (Rituxan®)
- abatacept (Orencia®)
- anakinra (Kineret®)
- certolizumab (Cimzia®)
- golimumab (Simponi®)
- ustekinumab (Stelara®)
- secukinumab (Cosentyx®)
- vedolizumab (Entyvio®)
- sarilumab (Kevzara®)
- azathioprine, cyclosporine, or other immunosuppressive drugs
- 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.
What are other possible side effects of XELJANZ/XELJANZ XR?
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. Your healthcare provider may do blood tests before starting and while using treatment with XELJANZ. Tell your healthcare provider if you have any signs of these symptoms: 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 in adults with rheumatoid arthritis and psoriatic arthritis include upper respiratory tract infections (common cold, sinus infections), headache, diarrhea, nasal congestion, sore throat, runny nose (nasopharyngitis), and high blood pressure (hypertension).
Common side effects in adults with ulcerative colitis include nasal congestion, sore throat, runny nose (nasopharyngitis), increased cholesterol levels, headache, upper respiratory tract infections (common cold, sinus infections), increased muscle enzyme levels, rash, diarrhea, and shingles (herpes zoster).
Common side effects in children (2 & older) with polyarticular juvenile idiopathic arthritis include upper respiratory tract infections (common cold, sinus infections), nasal congestion, sore throat, and runny nose (nasopharyngitis), headache, fever, nausea, and vomiting.
XELJANZ & Pregnancy
XELJANZ may affect the ability of females to get pregnant. It is not known if this will change after stopping XELJANZ. It is not known if XELJANZ will harm an unborn baby.
- Pregnancy Registry: Pfizer has a registry for pregnant women who take XELJANZ. 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, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at
You and your healthcare provider should decide if you will take XELJANZ or breastfeed. You should not do both. After you stop your treatment with XELJANZ do not start breastfeeding again until 18 hours after your last dose of XELJANZ or 36 hours after your last dose of XELJANZ XR.