Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis
Authors' conclusion
As used in present clinical practice in Sweden, we found no evidence that CV risk is higher with JAKis than TNFis in RA.
Study context
- Population
- Patients with rheumatoid arthritis (RA) initiating janus kinase inhibitors (JAKi), tumour necrosis factor inhibitors (TNFi) or non-TNFi biological disease-modifying antirheumatic drugs (bDMARDs) in the Swedish Rheumatology Quality Register, 2016–2021, followed until 2022
- Participants
- 13,492 patients
- Exposure
- JAKi vs non-TNFi bDMARD vs TNFi in RA
- JAKin = 3,037
- Outcome
- Incident MACE:
- MI
- Stroke
- Fatal CV events
Methodological detailsregister-based, multivariable Cox regression, age-sex standardised rates
- Register-based
- Multivariable Cox regression
- Age-sex standardised rates
Main finding
As reported in the abstract
MACE
Each group vs TNFiHazard ratio (95% CI)
JAKi
0.71(0.51–0.99)
Non-TNFi bDMARD
0.98(0.78–1.23)
Observational data: associations, not effects.
Further findings
Major acute CV event (MACE) HR over time since treatment initiation
- No evidence that the HR changed over time since treatment initiation
MACE in cardiovascular (CV)-enriched subset (subgroup)
- Higher rates but similar HRs
Original publication
Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis. RMD Open. Published 23 November 2023. doi:10.
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