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Xeljanz vs. Stelara?

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Ulcerative Colitis
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Posted 10/7/2020 1:15 PM (GMT 0)
Hi everyone,

I've read through experiences with both drugs (Xeljanz vs. Stelara) but haven't seen any comparisons of the two. I was diagnosed with UC in 2009 and had much of my colon removed in an ileorectal anastomosis surgery back in 2010. I still have residual inflammation in my rectum (proctitis) but no bleeding. Normal day for me is about 3-5 BMs per day with varying urgency but when I flare up, that can increase.

My proctitis has been stubborn, and suppositories like Canasa and Uceris steroid foam have not really helped. Having taken mesalamines in the past when I had full-blown UC, I found those were unhelpful, so I'm considering a biologic.

Are the safety profiles and side effects for Xeljanz and Stelara relatively similar? Anyone know if one would be more inclined to work for rectal inflammation? As a matter of convenience, Stelara is more appealing since the maintenance does is just one injection every 8 weeks vs a pill twice a day, but other than that, I do not have a good baseline for comparing safety and efficacy, especially for someone in my situation with proctitis.

Any insight/recommendations would be helpful.

Thank you in advance.

--
Brandon
35 years old, male
Diagnosed with UC in 2009
Surgery (ileorectal anastomosis) in 2010
Active rectal inflammation
Posted 10/12/2020 6:06 PM (GMT 0)
Stelara and xeljanz are both pretty new meds, so few have tried them. We've had a few success stories for each posted on here. So they've helped some of us here.

Head-to-head comparisons of medications is exceedingly rare in medical literature, trials are expensive and getting funding for something novel like that is very difficult. The only head-to-head I know of for UC meds is humira vs entyvio, and entyvio came out on top in that study.

Stelara compares with the other biologics, just a different mechanism of action. The biologics are large proteins that act on the cellular surface.

Xeljanz is a tiny, inside the cell molecule. It's technically not a biologic but is often compared with them as it's an equally strong medication used in similar situations.

The safety record isn't long or extensive or long for either, but we're proven safe during their respective clinical trials. I know their were some post-market-release concerns with xeljanz and clotting, relieved mostly by lowering the dosage in the maintenance phase from 10mgs to 5mgs. Certainly do talk with your doctor whether you have any high clotting risks (most do not have said risk).

There's a chance either will help you, but we cannot say which is the best. I'd do your best educated guess based on cost and convenience. If you fail one, then try the other .
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