Tofacitinib for Myositis

How does Tofacitinib work?

The soldiers in the immune army use chemical “messages” to communicate and coordinate inflammation. These messages travel through special pathways inside immune cells called JAK (Janus Kinase) pathways.

Tofacitinib works by blocking these pathways, preventing inflammatory messages from being passed on.

• Blocks communication between inflammatory immune cells
• Prevents immune cells from receiving signals that drive inflammation
• Reduces muscle inflammation and weakness
• Helps improve skin rashes and joint symptoms

Uses

• Myositis (especially difficult-to-control skin disease)
• Rheumatoid arthritis
• Psoriatic arthritis
• Ulcerative colitis
• Other autoimmune and inflammatory diseases

How is Tofacitinib taken?

Tofacitinib is taken by mouth as a tablet — twice daily, or as an extended-release tablet once daily. Take it regularly at the same time each day. It can be taken with or without food.

Common side effects

Many people tolerate Tofacitinib well. Common side effects include headache, mild stomach upset, nausea, upper respiratory infections (cold-like symptoms), and a mild increase in cholesterol levels.

Why are blood tests necessary?

Tofacitinib can occasionally affect blood counts, liver function, and cholesterol levels. Your doctor will also screen for infections such as tuberculosis before starting treatment.

Missed dose

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your usual schedule. Do not take two doses together.

During infection

Contact your healthcare team if you develop high fever, hospital admission, persistent cough, or unexplained weight loss. Your doctor may advise temporarily stopping Tofacitinib until the infection improves.

Shingles (Herpes Zoster)

Tofacitinib can slightly increase the risk of shingles, a painful blistering rash caused by reactivation of the chickenpox virus. Seek medical attention promptly if you develop a painful rash, burning or tingling skin, or clusters of blisters on one side of the body.

Heart and blood clot risks

In adults with certain risk factors (especially older age, smoking history, or pre-existing heart disease), there may be a small increase in the risk of blood clots or cardiovascular problems. These complications are uncommon in children and young adults.

Pregnancy, breastfeeding, and vaccines

Pregnancy should be avoided while taking Tofacitinib. Discuss reliable contraception and future pregnancy planning. There is limited information regarding breastfeeding.

Inactivated vaccines are generally safe and annual flu vaccination is encouraged. Your doctor may recommend shingles vaccination before treatment in eligible patients. Live vaccines should usually be avoided.