Cancer risks with Janus kinase inhibitors (JAKi) and biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis or psoriatic arthritis: a national real-world cohort study
Main finding · Cancer other than NMSC, RAResult — go to the resultHazard ratio 0.94 95% CI 0.65–1.38Authors' conclusion
In clinical practice, the short-term risk of cancer other than NMSC in individuals initiating treatment with JAKi is not higher than for TNFi, but we found evidence of increased risk for NMSC.
Study context
- Population
- Patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) initiating JAKi, tumour necrosis factor inhibitors (TNFi) or non-TNFi biological disease-modifying antirheumatic drugs (bDMARDs) 2016–2020, Swedish Rheumatology Quality Register linked to the Cancer Register10,447 RA
- Exposure
- JAKi vs TNFi
- Outcome
- All cancers excluding NMSC, and individual cancer types including NMSC
Methodological detailsnational register-based, Cox regression
- National register-based
- Cox regression
Main finding
Cancer other than NMSC, RA
Hazard ratio
0.94
95% CI 0.65–1.38
Events by group
JAKi
38
events
TNFi
213
events
JAKivs TNFi
HR 0.94 (95% CI 0.65–1.38)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Events
| Outcome | JAKi | TNFi | HR (95% CI) | |
|---|---|---|---|---|
| Incident NMSC in RAJAKivs TNFi | 59 | 189 | 1.39 (1.01–1.91) | |
| 0.512Hazard ratio (log scale) |
Incident non-melanoma skin cancer (NMSC) in RA, ≥2 years since treatment start (JAKi vs TNFi) · 2 or more years since treatment start
- HR for NMSC at 2 or more years since treatment start
- 2.12 (95% CI 1.15 to 3.89)
Incident cancers other than NMSC in PsA (JAKi vs TNFi)
- Incident cancers other than NMSC, JAKi vs TNFi
- 5 vs 73
- HR
- 1.9 (95% CI 0.7 to 5.2)
Incident NMSC in PsA (JAKi vs TNFi)
- Incident NMSC, JAKi vs TNFi
- 8 vs 73
- HR
- 2.1 (95% CI 0.8 to 5.3)
Original publication
Cancer risks with JAKi and biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis or psoriatic arthritis: a national real-world cohort study. Ann Rheum Dis. Published 3 March 2023. doi:10.
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