Gastrointestinal Perforation as a Safety Concern Among Patients With Rheumatoid Arthritis Receiving JAK Inhibitor Therapy: A Systematic Review and Network Meta‐Analysis
Authors' conclusion
JAKi were not associated with an increased risk of GIP compared to csDMARDs in patients with RA.
Study context
- Population
- Adult patients with rheumatoid arthritis (RA) (age ≥18 years) in randomized controlled trials (RCTs) comparing JAK inhibitors (JAKi) with other comparators and reporting gastrointestinal perforation (GIP)
- Participants
- 20,023 patients23 RCTs
- Comparison
- JAKi vs conventional synthetic disease-modifying antirheumatic drugs (csDMARDs)
- JAKin = 12,430
- Outcome
- Risk of gastrointestinal perforation (GIP)
Methodological detailsrandom-effects model, pairwise and network meta-analysis, SUCRA ranking
- Random-effects model
- Pairwise and network meta-analysis
- SUCRA ranking
Pooled result
As reported in the abstract
Gastrointestinal perforation
JAKi
0.19%
24 of 12,430
JAKi vs csDMARDsRelative risk (95% CI)P value
Pairwise meta-analysis; I2 = 0.0%
1.02(0.41–2.56)
Network meta-analysis; no inconsistency (P = 0.55)
0.83(0.37–1.84)
P = 0.64- SUCRA, JAKi
- 50.8%
- SUCRA, biologic DMARDs
- 77.0%
Original publication
Gastrointestinal Perforation as a Safety Concern Among Patients With Rheumatoid Arthritis Receiving JAK Inhibitor Therapy: A Systematic Review and Network Meta‐Analysis. Arthritis Care Res (Hoboken). Published 2 June 2025. doi:10.
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