No Major Risk of CVD Events With JAKs or bDMARDs in RA

Dutch researchers concluded that no significant difference in cardiovascular risks was seen among patients with rheumatoid arthritis (RA) treated with Janus kinase inhibitors (JAKi) or biologic disease-modifying drugs (bDMARDs).

Using IQVIA's Dutch Real-World Data Longitudinal Prescription database, which covers about 63% of outpatient prescriptions in the Netherlands, the study analyzed patients with RA who began using either JAKi or bDMARDs between August 2018 and January 2022. The study defined a cardiovascular event as the initiation of platelet aggregation inhibitors. Incidence densities of cardiovascular events were compared between the 2 groups using multilevel Poisson regression, adjusting for exposure time and confounding factors.

The study included 15,191 unique patients, with a total of 28,481 patient-years of treatment (2373 with JAKi and 26,108 with bDMARDs). Most patients were female (72%), with a median age of 62 years. During the study period, 36 cardiovascular events occurred in the JAKi group (1.52 events per 100 patient-years) and 383 in the bDMARDs group (1.47 events per 100 patient-years).

The adjusted incidence rate ratio (IRR) for JAKi compared to bDMARDs was 0.99 (95% CI: 0.70, 1.41), indicating no significant difference in cardiovascular risk between the two treatments. Subanalyses by age, sex, and specific JAKi drugs (tofacitinib and baricitinib) yielded similar results.

Reference
Popa CD, Opdam MAA, den Broeder N, et al. Therapy with JAK inhibitors or bDMARDs and the risk of cardiovascular events in the dutch rheumatoid arthritis population. Rheumatology (Oxford). 2024;63(8):2142-2146. doi:10.1093/rheumatology/kead531