From the Guidelines
Yes, Xeljanz (tofacitinib) and Rinvoq (upadacitinib) are in the same medication class, classified as Janus kinase (JAK) inhibitors, which target the JAK-STAT signaling pathway to block intracellular signaling involved in immune and inflammatory responses. These medications are used to treat similar conditions, including rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis, though their specific FDA approvals may differ slightly. Both medications carry similar black box warnings regarding risks of serious infections, malignancy, major adverse cardiovascular events, and thrombosis, as noted in the 2024 AGA living clinical practice guideline on pharmacological management of moderate-to-severe ulcerative colitis 1. Patients taking either medication require regular monitoring of blood counts, liver enzymes, and lipid levels, as recommended in the 2021 consensus statement on the treatment of immune-mediated inflammatory diseases with JAK inhibitors 1. The similar mechanism of action means that if a patient doesn't respond to one JAK inhibitor, switching to the other may not necessarily provide better results, though individual responses can vary, as discussed in the 2020 EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs 1. Key considerations for their use include cautious use in patients at risk for adverse cardiovascular outcomes, such as those with a history of cardiovascular disease or cancer, and avoidance in women of childbearing age contemplating pregnancy due to limited data on their safety during pregnancy, as highlighted in the 2024 guideline 1. In terms of efficacy, upadacitinib is considered a high-efficacy medication, while tofacitinib and filgotinib are considered moderate-efficacy medications, as noted in the 2024 guideline 1. Overall, the decision to use Xeljanz or Rinvoq should be based on an aggregate of contraindications, patient preference, and costs, as recommended in the 2020 EULAR guidelines 1.
From the FDA Drug Label
Tofacitinib is a Janus kinase (JAK) inhibitor. Upadacitinib is a Janus kinase (JAK) inhibitor.
Yes, Xeljanz (tofacitinib) and Rinvoq (upadacitinib) are in the same class of medications, specifically JAK inhibitors 2 3.
From the Research
Classification of Xeljanz and Rinvoq
- Xeljanz (tofacitinib) and Rinvoq (upadacitinib) are both Janus kinase (JAK) inhibitors, which suggests they belong to the same class of drugs 4, 5, 6, 7, 8.
- JAK inhibitors are a type of medication that work by blocking certain enzymes in the body, which are involved in inflammation and immune responses 4, 6, 7.
- Both Xeljanz and Rinvoq are used to treat rheumatoid arthritis (RA) and have shown efficacy in reducing symptoms and improving quality of life for patients with RA 4, 6, 7, 8.
Comparison of Xeljanz and Rinvoq
- Studies have compared the efficacy and safety of Xeljanz and Rinvoq, with some suggesting that Rinvoq may have a more favorable efficacy profile 7, 8.
- However, the safety profiles of Xeljanz and Rinvoq are similar, with both drugs carrying risks of serious heart-related events, cancer, blood clots, and death 5, 6, 7.
- The choice between Xeljanz and Rinvoq may depend on individual patient factors, such as medical history and response to treatment 6, 7, 8.
Key Similarities and Differences
- Both Xeljanz and Rinvoq are JAK inhibitors, but they have different selectivity profiles, with Rinvoq being more selective for JAK1 7.
- Xeljanz has a longer history of use and a more established safety profile, while Rinvoq is a newer drug with less long-term data available 4, 5, 6, 7, 8.
- Head-to-head clinical trials are needed to further compare the efficacy and safety of Xeljanz and Rinvoq 6, 8.