Tofcitinib (Xeljanz) and response to stress

Is the response to stress altered in those taking Tofacitinib (Xeljanz)?

Every day, I hear new about potentially new benefit for the immunosuppressive medication Tofacitinib (Xeljanz). Studies have shown benefit in a range of conditions including rheumatoid arthritis, alopecia areata, atopic dermatitis (excema of the skin), vilitilo, inflammatory bowel disease, ankylosing spondylitis and more. 

I've been using it for a while now for alopecia areata and seeing responses in a proportion of patients. Side effects are not common but include headaches, runny nose, diarrhea, changes in blood counts. Serious side effects don't appear to be common but issues like infection occur in about 2 % of users. 

As we continue to introduce Tofacintib to the clinical setting, it's important to continue to monitor all side effects.

Tofacitinib and agression

Today, I read a study from the Eur J Pharmacol about changes in aggressive behaviour in mice treated with tofacitinib

Aggression behaviour induced by oral administration of the Janus-kinase inhibitor tofacitinib, but not oclacitinib, under stressful conditions.

Fukuyama T, et al. Eur J Pharmacol. 2015.

 

A recent study in mice set out to determine if tofacitinib can affect itching in mice. IN the process of conducting the study,  In the process of detecting anti-itching potency, the researchers found that tofacitinib treated mice showed slightly increased aggressive behaviour after being 'stressed'. These studies showed not only that the JAK-STAT pathway (the pathway that tofacitinib acts on) may affect behaviour, but that these side effects should be further explored in humans treated with the medication. It's not always possible to draw parallels between mouse and human studies but this study leads the way to further investigation of possible behaviour changes induced by the medication.

REFERENCE

Fukuyama T, et al. Aggression behaviour induced by oral administration of the Janus-kinase inhibitor tofacitinib, but not oclacitinib, under stressful conditions. Eur J Pharmacol. 2015.