Information on how to access XELJANZ®▼ (tofacitinib citrate) prescribing information and adverse event reporting can be found at the bottom of the page.
The immune system is a complex but coordinated system of cells, tissues, and soluble molecules that constitute the body's defence against invasion by non-self entities, including infectious and inert agents and tumour cells.
Immune homeostasis is the delicate balance of all immune responses used to fight disease.1 Immune homeostasis is affected by a number of different factors, both inherited and acquired:
Immune homeostasis naturally fluctuates over time, but in some cases the balance of pro-inflammatory and anti-inflammatory responses can shift to a new equilibrium, leading to diseases characterised by chronic immunosuppression or chronic inflammation.1
Cytokines (greek, cyto- ‘cell’ & kinos – ‘movement’) are small molecules that mediate communication between cells resulting in:2
Cytokines may be classified according to function;2 however, the definition of cytokine function is ever-changing, with many cytokines playing multiple roles and falling into more than one category:
In immune homeostasis, a complex network of cytokines balances pro-inflammatory and anti-inflammatory effects.6,7 Autoimmune diseases are, broadly speaking, the result of an imbalance between pro- and anti-inflammatory cytokines. In chronic autoimmune diseases, for example rheumatoid arthritis, joint destruction is driven by cytokine release.
* IL-1Rα , IL-18BP , IL-10 , TGF-β , IL-11 , IL-13.
** TNF , LT , IL-1β , IL-6 , IL-7 , IL-8 , IL-12, IL-17, IL-18 , IL-23 , IFN
TNF-tumour necrosis factor; IL-interleukin; IFN-interferon; TGF-B- transforming growth factor-beta; G-CSF-Granulocyte-colony stimulating factor; GM-CSF-Granulocyte/Macrophage-colony stimulating factor; LT-Leukotrienes; IL-18BP-interleukin-18 binding protein; Th-T-helper cell; T reg-T-regulatory cell.
The chronic inflammatory state in autoimmune diseases occurs as a result of a continuing pro-inflammatory ‘cytokine loops’ whereby cytokines attract and stimulate immune cells to release more cytokines, which further stimulate production of cytokines. This process can lead to perpetuation or amplification of the inflammatory state.7
XELJANZ Risk Minimisation Programme (RMP) materials, including a Patient Alert Card, Prescriber Checklists and a Prescriber Brochure are available from https://www.medicines.org.uk/emc/. Patients treated with XELJANZ should be given the Patient Alert Card.
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PP-PFE-GBR-2688. December 2020