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Mediterr J Rheumatol 2024;35(Suppl 1):10-9
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Risk of Major Adverse Cardiovascular Events and Venous Thromboembolism with JAK Inhibitors versus TNF Inhibitors in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis
Styliani Partalidou1, Dimitrios Patoulias2, Kleopatra Deuteraiou3, Paraskevi Avgerou3, George Kitas4, Maria Tzitiridou-Chatzopoulou3, Theodoros Dimitroulas3
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11st Department of Internal Medicine, 424 Military Hospital of Thessaloniki, 56429, Thessaloniki, Greece
2Outpatient Department of Cardiometabolic Medicine, Second Department of Cardiology, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece

34th Department of Internal Medicine, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, 54642, Thessaloniki, Greece

4Research & Development, Dudley Group NHS Foundation Trust and University of Birmingham, United Kingdom

Abstract

Objective: The aim of this study was to compare the risk of major cardiovascular events (MACE) and venous thromboembolic events (VTE) between tumour necrosis factor (TNF) and Janus kinase (JAK) inhibitors in patients with rheumatoid arthritis (RA).  Methods: We researched PubMed, Scopus, Cochrane Library, and clinicaltrials.gov until December of 2023 for randomised controlled trials (RCTs) and observational studies. The outcomes studied were MACE (stroke, heart attack, myocardial infarction, sudden cardiac death) and VTE (deep vein thrombosis, pulmonary embolism). We pooled data using random effects model. Risk for the reported outcomes was expressed as odds ratio (OR) with a 95% confidential interval (CI). We performed a subgroup analysis based on study design. Results: We identified 23 studies, 20 of which compared the odds for MACE and 14 the odds for VTE between JAK and TNF inhibitors in RA patients. Ten studies were RCTs and the rest were observational. Regarding MACE risk we pooled data from a total of 215,278 patients (52,243 were treated with JAK inhibitors, while the rest 163,035 were under TNF inhibitors). Compared with TNF inhibitors, the OR for JAK inhibitors in regards with MACE risk was 0.87 (0.64-1.17, p<0.01). Regarding VTE, a total of 176,951 patients were analysed (41,375 JAK inhibitors users and 135,576 TNF inhibitors users). The OR for VTE for JAK inhibitors compared with TNF inhibitors was 1.28 (0.89-1.84, p<0.01). Conclusion: According to our results, there is no statistically significant difference for MACE or VTE in RA patients who receive either JAK or TNF inhibitors.



Cite this article as: Partalidou S, Patoulias D, Deuteraiou K, Avgerou P, Kitas GD, Tzitiridou-Chatzopoulou M, Dimitroulas T. Risk of Major Adverse Cardiovascular Events and Venous Thromboembolism with JAK Inhibitors versus TNF Inhibitors in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis. Mediterr J Rheumatol 2024;35(Suppl 1):10-9.

 

Article Submitted: 17 Oct 2023; Revised Form: 07 Dec 2023; Article Accepted: 11 Dec 2023; Available Online: 30 Mar 2024

This work is licensed under a Creative Commons Attribution 4.0 International License.

©2024 The Author(s).

https://doi.org/10.31138/mjr.171023.rof

Keywords: JAK inhibitors, TNF inhibitors, rheumatoid arthritis, thromboembolic events, cardiovascular events