Is it safe to take tofacitinib/Shangjie for a long time?

Tofacitinib is a widely used oral JAK inhibitor that is used in many countries around the world for the long-term management of rheumatoid arthritis, autoimmune diseases, etc. Therefore, "whether long-term use is safe" has naturally become one of the biggest concerns for patients. The long-term safety of tofacitinib is closely related to individual constitution, underlying diseases, dosage, the presence of comorbidities, and whether monitoring is standardized.

In other words, tofacitinib is not a type of drug that can be "taken casually for a long time", but a long-term treatment regimen that needs to be maintained under strict follow-up. Overseas professional institutions emphasize that the long-term risks of tofacitinib mainly focus on the regulation of immune function. Since the drug inhibits inflammatory signaling pathways, the body's defense ability against bacteria or viruses may be reduced. Therefore, patients need to pay more attention to infection signals during long-term treatment, including persistent fever, worsening cough, repeated redness and swelling of the skin, etc. Once these symptoms occur, you should seek medical evaluation as soon as possible.

During long-term medication, monitoring of blood picture, liver function, kidney function and blood lipid levels is essential. The dose of tofacitinib is usually gradually adjusted by doctors based on the patient's metabolism and symptom control, rather than "one dose to the end". The safety strategy for long-term use puts more emphasis on individualized adjustment and risk stratification, that is, for patients who are older, have cardiovascular risk factors, or are accompanied by other immunosuppressive treatments, the frequency of monitoring needs to be relatively high, while younger patients with fewer underlying diseases have a lower relative risk. Although tofacitinib occasionally causes gastrointestinal discomfort or mild headache, most of them can gradually improve after continued treatment, and patients do not need to blindly stop taking the drug due to short-term discomfort.

Reference materials:https://www.xeljanz.com/