Xeljanz (tofacitinib) is a medication prescribed to manage specific autoimmune conditions, including rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. Changes in body weight are a common concern for patients taking medications like Xeljanz. This article explores whether Xeljanz can cause weight gain.
Investigating Xeljanz and Weight Gain
Weight gain is a reported side effect of Xeljanz. Clinical trials involving over 5,000 patients indicate that individuals taking Xeljanz are more likely to experience weight gain and an increase in body mass index (BMI) compared to those receiving a placebo. This weight increase is generally modest, often occurring within the first year of treatment. For instance, patients typically experienced a mean weight gain of 1.2 to 1.9 kilograms (2.6 to 4.2 pounds) after six months and 2.0 to 2.6 kilograms (4.5 to 5.6 pounds) after twelve months.
A significant proportion of Xeljanz users experience this weight change; between 65% and 70% of individuals on Xeljanz gained some weight after six months, compared to 55% in placebo groups. Additionally, 16% to 28% of patients taking Xeljanz saw a 5% or greater increase in their weight after six months, whereas this was observed in 11% of those on placebo. While Xeljanz works by reducing inflammation, which can influence body weight, studies suggest a direct impact of the medication on weight.
Potential Biological Pathways
Xeljanz functions as a Janus kinase (JAK) inhibitor, targeting specific enzymes (JAK1, JAK2, JAK3, and TYK2) that play a role in the immune system’s signaling pathways. These pathways are involved in inflammation, which Xeljanz aims to reduce. The inhibition of JAK enzymes might also influence metabolic processes within the body.
One proposed mechanism involves the hormone leptin, which helps regulate appetite and energy expenditure. JAK2, an enzyme inhibited by Xeljanz, is involved in leptin signaling in the brain. Disrupting this signaling could potentially interfere with the brain’s ability to sense satiety, leading to an increased appetite and subsequent weight gain. Changes in overall energy expenditure have also been noted with other JAK inhibitors, suggesting a broader metabolic impact. The precise ways Xeljanz affects body weight are still being investigated.
Strategies for Weight Management
Individuals concerned about or experiencing weight gain while taking Xeljanz can consider various lifestyle interventions. Adopting a balanced nutritional approach is a helpful step, focusing on whole foods, practicing portion control, and engaging in mindful eating habits. Limiting foods and beverages high in calories, sugar, and unhealthy fats can also support weight management.
Regular physical activity is another important component, with general recommendations suggesting at least 150 minutes of moderate-intensity aerobic exercise each week. This can include activities such as brisk walking, swimming, or cycling, tailored to individual abilities and health conditions. Incorporating other supportive lifestyle habits, like ensuring adequate sleep and managing stress effectively, can also contribute to maintaining a healthy weight.
Consulting Your Healthcare Provider
It is important to discuss any weight concerns or other side effects with the prescribing physician. Patients should not adjust or discontinue Xeljanz without medical guidance. A healthcare provider can evaluate potential other causes of weight gain, review the medication regimen, and offer personalized dietary and exercise recommendations.
The doctor might also suggest a referral to a dietitian for tailored nutritional advice. The decision to continue or modify treatment should always be a collaborative one between the patient and their doctor. This ensures that the benefits of controlling the underlying condition are weighed against any potential side effects.