Anybody on Xeljanz? Please help.

Hi Sunshine - I'm on Xeljanz and have been for about 6 months. Prior to that I took almost every biologic available, including Actemra. I've had absolutely no problems with Xeljanz and I find it pretty comparable to when I was on Actemra. In my case, it's not so much that Actemra was unsuccessful, but that it was really inconvenient for me to schedule infusion apts on the one day my doctor's office does them. Especially because I work full-time, it's nice to not have to deal with losing a half-day monthly to do infusions anymore. I should give you the caveat that I'm one of those lucky people who rarely experience a side effect from meds, so take my experience with Xeljanz with a grain of salt. And as to side effects, once you start getting into the drug range that treats "moderate to severe RA", as they say in the commercials - well, they all have potentially nasty side effects, unfortunately. Xeljanz' are less well-known since it's been on the market for a shorter period of time, but it's all a gamble, frankly.

My question is this - has your doctor shared with you what the sub-results are from the test? Not just your overall score, but what your individual protein markers are? Are they recommending a change in your treatment on the basis of the protein markers measured, or because you're not responding to Actemra? It's possible that you should be trying another TNF blocker (ie, any other biologic other than Actemra), especially if you do not overproduce IL-6, which is what Actemra treats. You may do better on infusions than taking tablets, especially given the experience you had on Arava.

I hope this is helpful and that you're able to have a good conversation with your rheumy.

I think a little balance may be needed on the discussion thread here. The following things are true and based on my own personal experience, which makes them as important to me personally as reading about recommendations and research:

* No biologic targeting TNF ever worked for me, and I've had this disease for about 14 years now. No doctor could explain why; we just kept trying one med after another.

* Actemra, the only biologic that inhibits IL-6, was the last on the list of things for me to try. To get to it, I had to try and presumably fail 2 more biologics over a six-month period, which means it would have taken me a year to get an IL-6 inhibitor if it were not for the Vectra-DA test.

* The Vectra test's individual biomarker levels were *interpreted by my rheumatologist*, not Crescendo, the maker of the test. This may be an important distinction to make here - that a qualified practitioner made the assessment himself, though I should point out that I saw a copy of the results and I could see for myself that they clearly showed the overproduction of IL-6 proteins vs TNF and other inflammatory markers percentage-wise. In that sense it's like routine lab work that isn't interpreted by the laboratory that tested you either; your doctor does that along with other tests and observations. Crescendo themselves emailed me that the physician receives the breakdown of the biomarkers along with the overall score, and I think it can't hurt you to ask about that breakdown (btw, I'm not affiliated with Crescendo in any way and have nothing to gain by sharing my personal experience).

* The change from Remicade to Actemra was the first drug (other than prednisone) that significantly eased my pain, slowed the progression of my disease, restored much of my energy and allowed me to resume hiking and jogging for the first time in many years. I won't add anything to this discussion beyond that - getting that relief one year sooner based on that test made all the difference for me.

Sunshine, I hope that whatever treatment you and your doctor decide on is right for you and gives you the pain relief and restored function you need to feel well.

trinaunz - I have been on Actrema for 4 years now. It has done well to keep my sed rate down but I was still having problems this last year. This is when I had my first Vectra DA test done. My IL-6 was 180 and now it is 230. My Leptin and Resistin are elevated also.

In the past 2 1/2 years I've had both knees replaced, rotator cuff repair with debridement and most recently cervical fusion. I still have erosion going on, so that is why my Rheumy wants to change to Xeljanz.

I have had RA for 24 years and now it is in the state of high activity and I am running out of options. I either am allergic to the med or it quits working. With Xeljanz being so new and the last thing to try for now I was just wondering about the side effects and how others have responded to it.

I'm glad it has done well for you. I hope it continues to work for you.

Thank you to both of you for your input. I appreciate it very much.