Cardiovascular and Venous Thromboembolic Risk With JAK Inhibitor Treatment of Skin Disorders Save

A JAMA systematic review and meta-analysis has showed the use of JAK inhibitors (JAKi) in immune-mediated inflammatory skin diseases was not associated with increased risk of all-cause mortality, major adverse cardiovascular events (MACE), or venous thromboembolism (VTE) (compared to the placebo or active comparator cohorts).

This meta-analysis included 35 randomized clinical trials and over 20651 patients (mean age 38.5 yrs) with dermatologic conditions treated with JAKi and followed for a mean of 4.9 months. Results showed no significant differences between JAK inhibitors and placebo/active comparator in composite MACE and all-cause mortality (OR, 0.83; 95% CI, 0.44-1.57) or VTE (OR, 0.52; 95% CI, 0.26-1.04).

These retrospective findings differ from that seen with the prospective Oral Surveillance trial, which was also different by being prospective and included older rheumatoid arthritis patients (vs younger Dermatology patients) at high risk for MACE and other CV events.

Without having comparable prospective data, this metanalysis hints that short-term (<5 months) use of JAK inhibitors for a dermatologic indication likely may not associated with an increased risk of all-cause mortality, MACE, and VTE.

Additional trials with long-term follow-up are needed to better understand the safety risks of JAK inhibitors used for dermatologic indications.