Opportunistic Infections with JAK inhibitors in RA Save

Winthrop and colleagues have reviewd the occurrence of opportunistic infections (OIs) associated with the use of Janus kinase (JAK) inhibitors in patients with rheumatoid arthritis (RA), showing that Herpez zoster (HZ) was the most common OI reported with JAK inhibitors in clinical trials, although tuberculosis (TB) and other OIs were also reported. 

Structured literature searches found105 publications describing 62 unique clinical trials reporting the rates of OIs in RA patients treated with JAK inhibitors.

With JAK inhibitor use in clinical trials, herpes zoster (HZ) infection (any form) was the most frequently reported OI, followed by TB and other OIs. Amongst other OIs PCP, and candidiasis were less common, with other OIs were rare (e.g., cytomegalovirus, cryptococcosis, coccidioidomycosis, aspergillosis and LM infection). 

There were no direct comparison between JAK inhibitors as there were no head-to-head trials. Higher rates were noted with higher doses of most JAK inhibitors and also in in Asian and Australian populations compared with the global population. 

More long-term safety studies in the real-world setting are needed to compare the risk of OIs between various JAK inhibitors.

safety studies with long-term follow-up in the real-world setting are needed to fully elucidate the safety profile and enable judicious use of the different JAK inhibitors