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TOPLINE: 

In adults aged 50 years or older with atopic dermatitis (AD), oral JAK inhibitors were not associated with a significant increase in the risk for major adverse cardiovascular events (MACE) or venous thromboembolism (VTE) compared with non-JAK systemic therapies, according to a study. 

METHODOLOGY:

• Researchers queried the TriNetX Global Collaborative Network to compare adults aged ≥ 50 years with AD who started oral JAK inhibitors (abrocitinib, baricitinib, ritlecitinib, tofacitinib, or upadacitinib) with those who started non-JAK systemic therapies (cyclosporine, dupilumab, or methotrexate,) the control group.
• After 1:1 propensity score matching based on age, sex, race and ethnicity, prior inpatient encounters, asthma, long-term systemic corticosteroid use, and cardiometabolic conditions, 1390 patients on JAK inhibitors (mean age, 64.7 years; 56.0% were women; 75.5% were not Hispanic or Latino, 66.2% were White, and 11.9% were Black or African American) and an equal number of patients who received non-JAK therapies were included.
• The primary outcome was MACE (nonfatal myocardial infarction or stroke), while the secondary outcome was VTE, including pulmonary embolism or deep venous thrombosis.

TAKEAWAY:

• The incidence of MACE was similar in the JAK inhibitor and non-JAK therapy groups (2.52% vs 2.66%; relative risk [RR], 0.95; 95% CI, 0.60-1.49).
• VTE occurred in 1.73% of those on a JAK inhibitor and 1.80% of those on non-JAK therapies (RR, 0.96; 95% CI, 0.55-1.67), indicating no significant difference in thromboembolic risk.
• In comparator-restricted analyses, no significant risks for MACE or VTE were noted with JAK inhibitors vs cyclosporine, dupilumab, and methotrexate.

IN PRACTICE:

"Overall, these findings did not identify a statistically significant difference in short-term MACE or VTE between oral JAK inhibitors and non-JAK systemic therapies in adults aged 50 years and older with AD," the authors wrote. "However," they added, "the estimates were imprecise, and larger studies with longer follow-up are needed before definitive conclusions about comparative cardiovascular and thromboembolic safety can be drawn."

SOURCE:

The study was led by Raymond Z. Ezzat, BS, and Meshi Paz, BS, Lahey Hospital & Medical Center, Burlington, Massachusetts, and was published online June 2 in Journal of the American Academy of Dermatology.

LIMITATIONS: 

Limitations included possible misclassification of MACE and VTE because the study relied on diagnosis codes, shorter follow-up in the JAK inhibitor group, and no minimum treatment duration. The use of different comparator groups and a propensity-matched cohort limited generalizability, and fatal events were not captured. The sample was underpowered to assess rare serious adverse events.

DISCLOSURES:

The study did not receive any specific funding. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.