Non-negligible risk of HBV reactivation among rheumatoid arthritis patients receiving JAK inhibitors: bridging the evidence gap
Authors' conclusion
Our findings reveal a non-negligible risk of HBV reactivation among RA patients receiving JAKi therapy, particularly with the more JAK1-selective JAKis.
Study context
- Population
- Patients with RA and available baseline HBV status treated with TNF inhibitors (TNFis), rituximab or JAKis, National Taiwan University Hospital, 2015–202335 HBsAg-positive
- Exposure
- JAKis vs TNFis or rituximab
- Outcome
- Hepatitis flare in HBsAg-positive patients and HBsAg seroreversion in HBsAg-negative/anti-HBc-positive patients
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
HBV reactivation in resolved HBV infection (HBsAg-negative/anti-HBc-positive)
| Group | Value | Incidence |
|---|---|---|
| TNFis | 0.9% | 2.8/1000 person-years |
| Rituximab | 3.2% | 15.1/1000 person-years |
| JAKis | 2.9% | 10.3/1000 person-years |
| Upadacitinib | 6.5% | 42.8/1000 person-years |
| Baricitinib | 4.7% | 19.2/1000 person-years |
| Tofacitinib | 1.0% | 2.7/1000 person-years |
Value
TNFis0.9%
Rituximab3.2%
JAKis2.9%
Upadacitinib6.5%
Baricitinib4.7%
Tofacitinib1.0%
Incidence
TNFis2.8/1000 person-years
Rituximab15.1/1000 person-years
JAKis10.3/1000 person-years
Upadacitinib42.8/1000 person-years
Baricitinib19.2/1000 person-years
Tofacitinib2.7/1000 person-years
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Hepatitis flare in HBsAg-positive patients (co-primary) | JAKis 50% |
Original publication
Non-negligible risk of HBV reactivation among rheumatoid arthritis patients receiving JAK inhibitors: bridging the evidence gap. Rheumatology (Oxford). Published 6 August 2025. doi:10.
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