Use of statins and its association with major adverse cardiovascular events with tofacitinib vs TNF inhibitors in patients with rheumatoid arthritis with and without atherosclerotic cardiovascular disease
Authors' conclusion
Among patients with a history of ASCVD, use of statins may mitigate the previously reported MACE risk observed to accompany tofacitinib use vs TNFi.
Study context
- Population
- Patients with rheumatoid arthritis (RA) aged ≥50 years and ≥1 additional cardiovascular (CV) risk factor
- Participants
- 1,455 / 1,456 / 1,451
- Comparison
- Tofacitinib 5 mg or 10 mg twice a day vs TNFi, by statin use
- Tofacitinib 5 mgn = 1,455
- Tofacitinib 10 mgn = 1,456
- TNFin = 1,451reference
- Primary endpoint
- Incident MACE by statin use in participants with a history of ASCVD and in categories of predicted CV risk
Primary result
As reported in the abstract
MACE in participants with history of ASCVD, by statin use
Tofacitinib vs TNFiHazard ratio (95% CI)
History of ASCVD and no use of statins at any time
4.07(1.20–13.82)
History of ASCVD and use of statins at baseline or at any time; no difference
1.17(0.46–3.00)
Further findings
Baseline statin use
- History of atherosclerotic cardiovascular disease (ASCVD)
- 53.0%
- High CV risk
- 26.9%
- Similar in tofacitinib and TNFi-treated participants
LDL and HDL change from baseline
- LDL and HDL increased from baseline, to a larger extent with tofacitinib than with TNFi, with or without statins
Original publication
Use of statins and its association with major adverse cardiovascular events with tofacitinib vs TNF inhibitors in patients with rheumatoid arthritis with and without atherosclerotic cardiovascular disease. Ann Rheum Dis. Published 23 September 2025. doi:10.
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