Comparison of risks of cancer, infection, and major adverse cardiovascular events (MACEs) associated with Janus kinase (JAK) inhibitor and TNF inhibitor treatment: a multicentre cohort study
An erratum to this article was published (Rheumatology (Oxford), 1 Dec 2023 ↗)
Authors' conclusion
The infectious disease IR in RA was comparable between tofacitinib and baricitinib, but the IR for HZ in these treatment groups was high compared with that in the TNF inhibitor treatment group. The malignancy rate in the JAK-inhibitor-treated group was high but not significantly different from that of the general population or that of the TNF-inhibitor-treated group.
Study context
- Population
- RA patients treated with tofacitinib, baricitinib or a TNFi
- Participants
- 499 patients959.7 patient-years
- Exposure
- JAKi vs TNFi
- Tofacitinibn = 192
- Baricitinibn = 104
- TNF inhibitorn = 203reference
- Outcome
- IRs of infectious diseases, MACEs and malignancies
Methodological detailsmulticentre, propensity score weighting, multivariable Cox regression
- Multicentre
- Propensity score weighting
- Multivariable Cox regression
Main finding
As reported in the abstract
Serious infectious diseases other than herpes zoster (HZ), JAKi
8.36/100 PY
HZ, JAKi
13.00/100 PY
Observational data: associations, not effects.
Further findings
| Outcome | SIR (95% CI) |
|---|---|
| Malignancy and MACE in JAKi-treated patientsJAKi vs General population · non-significantly higher | 1.61/100 PY (0.80–2.88) |
- Malignancy and MACE in JAKi-treated patients — MACEs, JAKi
- 2
- Malignancy and MACE in JAKi-treated patients — Malignancies, JAKi
- 11
Independent risk factors (multivariable Cox regression)
- GC dose for serious infectious diseases other than HZ; older age for HZ
Original publication
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