What should I pay attention to when taking Tofacitinib?

Tofacitinib (Tofacitinib)is a type ofJanus kinase (JAK) inhibitor. During treatment with tofacitinib, patients should pay attention to the occurrence of serious infections, malignant tumors, adverse cardiovascular events, thrombosis, gastrointestinal perforation, allergies and other adverse events. Patients who undergo vaccination should also follow the doctor's advice.

1. Infection: Patients receiving tofacitinib have developed serious and sometimes fatal infections caused by bacteria, mycobacteria, invasive fungi, viruses or other opportunistic pathogens. The most common serious infections reported include pneumonia, cellulitis, herpes zoster, urinary tract infection, diverticulitis, and appendicitis, and postmarketing cases of hepatitis B reactivation have also been reported.

2. Malignant tumors: Tofacitinib is associated with an increased risk of lymphoma (such as Epstein-Barr virus-associated lymphoma) and other malignant tumors (including lung cancer, breast cancer, gastric cancer, and colorectal cancer). It is recommended to monitor lymphocytes, neutrophils, hemoglobin, liver enzymes, and lipids.

3. Adverse cardiovascular events: The incidence of major adverse cardiovascular events, defined as cardiovascular death, nonfatal myocardial infarction (MI), and nonfatal stroke, is high. Patients with myocardial infarction or stroke should discontinue tofacitinib.

4. Thrombosis: Patients treated with tofacitinib and other Janus kinase (JAK) inhibitors used to treat inflammatory diseases have experienced thrombosis, including pulmonary embolism (PE), deep vein thrombosis (DVT) and arterial thrombosis, which may also lead to death.

5. Gastrointestinal perforation: Tofacitinib should be used with caution in patients who may be at increased risk of gastrointestinal perforation (such as patients with a history of diverticulitis or taking NSAIDs). Patients who develop new abdominal symptoms should be evaluated immediately to facilitate early identification of gastrointestinal perforation.

6. Allergy: Reactions that may reflect drug allergy, such as angioedema and urticaria, have been observed in patients receiving tofacitinib, and some events have been severe. If a serious allergic reaction occurs, tofacitinib should be discontinued immediately.

7. Vaccination: Clinical studies have shown that a patient received a live attenuated vaccine 16 days after and at the beginningTransmission of the varicella zoster virus vaccine strain occurred after 2 days of treatment with tofacitinib 5 mg twice daily, so the drug was discontinued and the patient recovered after receiving standard doses of antiviral medication.

Tofacitinibhas been launched in China and has entered the scope of Class B medical insurance. The common specification is tofacitinib citrate tablets. The price paid by medical insurance is relatively cheap, but the reimbursement ratio is different in different regions, and the price after reimbursement will be different. Overseas, there are also tofacitinib generic drugs produced in other countries. The price of each box produced by a Bangladeshi pharmaceutical factory is around RMB 300 (the price may fluctuate due to the exchange rate). The ingredients of domestic original drugs and foreign generic drugs are basically the same, and the prices of different specifications will be different.