Real-world comparison of herpes zoster risk among five Janus kinase inhibitors in rheumatoid arthritis: The ANSWER cohort study
Authors' conclusion
Filgotinib showed a lower observed risk of HZ compared with tofacitinib, baricitinib, and upadacitinib.
Study context
- Population
- Patients with RA initiating a Janus kinase inhibitors (JAKi) in the multicenter ANSWER cohort (84.1% female; mean age 63.9 years; mean follow-up 18.2 months)1,096 treatment courses
- Participants
- 765 patients
- Exposure
- Herpes zoster risk among five JAKi: tofacitinib, baricitinib, peficitinib, upadacitinib and filgotinib
- Outcome
- Incidence of herpes zoster (HZ)
Methodological detailsmulticenter, Cox proportional hazards models adjusted for patient characteristics, Kaplan-Meier methods
- Multicenter
- Cox proportional hazards models adjusted for patient characteristics
- Kaplan-Meier methods
Main finding
As reported in the abstract
HZ, IR per 100 person-years and adjusted HR
Each group vs filgotinibHazard ratio (95% CI)P value
Tofacitinib
7.68(1.71–34.6)
P = 0.008Baricitinib
6.35(1.48–27.1)
P = 0.013Upadacitinib
4.75(1.11–20.3)
P = 0.036- Treatment courses with herpes zoster (HZ) during follow-up
- 88
Observational data: associations, not effects.
Further findings
Treatment retention
- No significant differences observed
Patient-related variables (age, sex, prior HZ, vaccination history) and HZ risk
- Not significantly associated with HZ risk
Original publication
Real-world comparison of herpes zoster risk among five Janus kinase inhibitors in rheumatoid arthritis: The ANSWER cohort study. Joint Bone Spine. Published 26 May 2026. doi:10.
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