Loading ...

TOPLINE:

Patients with rheumatoid arthritis (RA) treated with Janus kinase (JAK) inhibitors showed no increased incidence of major adverse cardiovascular events (MACEs) compared with those treated with tumour necrosis factor (TNF) inhibitors or biologic disease-modifying antirheumatic drugs (bDMARDs) with other modes of action during the first 2 years of therapy.

METHODOLOGY:

• Researchers analysed data from 15 registries in a multicountry observational study (JAK-pot collaboration) to compare the incidence of MACEs in patients with RA treated with JAK inhibitors with that in those treated with other alternatives such as TNF inhibitors or bDMARDs with other modes of action.
• They included data of 51,233 adult patients (mean age, 58.4 years; 76% women) with 73,008 treatment courses including 16,417 with JAK inhibitors, 35,373 with TNF inhibitors, and 21,218 with bDMARDs with other modes of action.
• The primary outcome was the incidence of MACEs, defined as the occurrence of any stroke, myocardial infarction, or transient ischaemic attack.
• Two analysis approaches were used: A within-registry analysis for five registries using random-effects meta-analysis techniques and a combined data analysis using pooled data for the individual treatment course.
• The median follow-up duration from treatment initiation was 1.5 years for both JAK and TNF inhibitors and 1.0 year for bDMARDs with other modes of action.

TAKEAWAY:

• A total of 743 MACEs were recorded in the within-registry analysis and 289 MACEs were recorded in the combined data analysis across 14 registries.
• In the within-registry analysis, no significant difference in the incidence of MACEs was observed between JAK and TNF inhibitors; however, the incidence was higher with bDMARDs with other modes of action than with TNF inhibitors (adjusted incidence rate ratio, 1.35; 95% CI, 1.10-1.66).
• The combined data analysis showed no significant differences in the incidence of MACEs between TNF inhibitors and either JAK inhibitors or bDMARDs with other modes of action.
• A subgroup analysis of patients with an increased risk for MACEs in both the within-registry and combined data analyses showed consistent results, indicating no elevated cardiovascular risk with JAK vs TNF inhibitors.

IN PRACTICE:

"RA patients treated with JAKi [JAK inhibitors] do not incur an increased risk of MACE compared to alternative bDMARDs, particularly within the first two years of therapy," the authors wrote.

SOURCE:

This study was led by Romain Aymon, MSc, Geneva University Hospital, Geneva, Switzerland. It was published online on April 15, 2025, in Arthritis & Rheumatology.

LIMITATIONS:

Variations in reporting may have persisted between different registries. The number of events was limited, particularly for subgroup analyses and secondary outcomes. Only about 30% of the follow-up period extended beyond 2 years, with 20% of MACEs occurred after the 2-year mark.

DISCLOSURES:

The JAK-pot study received unrestricted research grants from AbbVie, Galapagos, Pfizer, and Eli Lilly. Many of the registries received funding and grants from various industry and public sources, including pharmaceutical, biotech, and healthcare companies; several government departments; hospitals; and other agencies. Several authors reported receiving unrestricted research grants; consulting, speaker, and lecturer fees; and honoraria from various sources.

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