Risk of first and second primary keratinocyte cancers in relation to treatment of rheumatoid arthritis with Janus kinase inhibitors (JAKi), tumour necrosis factor inhibitor (TNFi), and non-TNFi biologic disease-modifying antirheumatic drugs (bDMARDs)—a Swedish nationwide study
Authors' conclusion
Patients treated with JAKi have an elevated risk of KC compared with patients treated with TNFi.
Study context
- Population
- Patients with rheumatoid arthritis (RA) treated with JAKi, TNFi or non-TNFi bDMARDs, Sweden, 2012 through 2023
- Participants
- 21,756 patients
- Exposure
- JAKi or non-TNFi bDMARDs vs TNFi
- Outcome
- Incident keratinocyte cancer (KC)
Methodological detailsregister-based (Swedish Rheumatology Quality Register linked to National Cancer Register), Cox regression, TNFi as reference
- Register-based (Swedish Rheumatology Quality Register linked to National Cancer Register)
- Cox regression
- TNFi as reference
Main finding
As reported in the abstract
Incident KC
JAKi
155
events
Non-TNFi
458
events
TNFi
766
events
Each group vs TNFiAdjusted hazard ratio (CI)
JAKi1 extra KC case per every 244 patients per year
1.39(1.16–1.68)
Non-TNFi
0.96(0.86–1.08)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (CI) | |
|---|---|---|
| Basal cell carcinomaJAKivs TNFi | 1.41 (1.13–1.75) | |
| Squamous cell carcinoma (SCC)JAKivs TNFi | 1.49 (1.09–2.05) | |
| Squamous cell carcinoma (SCC)Abataceptvs Etanercept | 1.48 (1.11–1.97) | |
| Second primary KCJAKivs TNFi | 1.31 (0.94–1.82) | |
| Second primary KCNon-TNFivs TNFi | 0.94 (0.75–1.17) | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Risk of first and second primary keratinocyte cancers in relation to treatment of rheumatoid arthritis with JAKi, TNFi, and non-TNFi bDMARDs—a Swedish nationwide study. Ann Rheum Dis. Published 12 March 2026. doi:10.
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