0:03
Hello, I'm Sheila Reyes from the Philippines reporting here at ACR 2026 in Orlando, Florida.
0:10
And I'm with Dr. Marina Magri from Case Western Reserve University to talk about abstract number 2304 on real world data comparing risks of MACE and VTE on patients with PsA on JAK inhibitors and biologics.
0:30
Hi Marina, thank you for joining us today.
0:31
Hi, nice to see you Sheila. Yes, nice to see you too.
0:39
So please tell us more about your research.
0:42
So this was a very intriguing question as you were familiar that in the ORAL Surveillance study it was shown that there is increased risk of MACE events with tofacitinib in rheumatoid arthritis patients.
0:54
So it piqued our interest. We wanted to see does that risk carry over in patients with psoriatic arthritis, and we also looked at in a different abstract at ankylosing spondylitis.
1:04
Since psoriatic arthritis patients — there is a meta-analysis that was done few years ago by Leder which showed that there was increased risk of cardiovascular events in these patients, you know, despite the additional risk from medications.
1:18
So we chose to use this large database called TriNetX.
1:22
You know, it's a large database which has millions of data collections from institutions all over the world.
1:30
So that's the strength of the database, and we also used one of our clinical biostatisticians who have expertise in extracting the data from this large database.
1:39
So we get accurate data. No patients are double recorded in the study and we make sure the index dates are accurate.
1:47
So we took these patients — there were thousands of patients with psoriatic arthritis.
1:53
These patients had to be treatment naive.
1:56
They had to not be treated with any DMARD or with a biologic or a JAK inhibitor on the index date.
2:04
They were supposed to not have any preceding MACE events in the last 12 months or within the 30 months of medication initiation.
2:10
They were all excluded. And then we tried to do a propensity matching, so we made the cohorts uniform.
2:17
And what we interestingly found was that as the duration of treatment went up — the longer these patients stayed on treatment — at 2 and a half years we saw there was an increased risk of MACE events in all the groups: TNF inhibitors, IL-17 inhibitors, IL-23, and JAK.
2:37
But JAK inhibitors had substantially higher risk of MACE events compared to these four groups, and what we saw was that TNF inhibitors and IL-17 inhibitors actually had a statistically significant risk compared to JAK inhibitors.
2:52
I see, that's very interesting and remarkable work.
2:55
And from that, what key takeaways would you give our clinicians out there managing patients with PsA?
3:03
I think these data help us to understand that we need to risk stratify our patients when we are initiating biologic or targeted synthetic DMARD treatment in these patients.
3:16
We need to see what their comorbidities are.
3:20
Like in our own clinic, coronary artery calcium scoring is available without any cost to our patients.
3:29
So if I am planning to initiate, let's say, a JAK inhibitor in a patient and they may have some comorbidities, I often order it to make sure to see how the coronary artery calcium burden is before I put them on, so that we decrease the risk in our patients of any adverse events.
3:47
So risk stratification before starting, using some common sense judgment, and then deciding upon the therapy is the take-home message from this abstract.
3:54
Okay, very well said. And just a few more — are there any future directions with regards to your present study?
4:02
We are actually also doing some transcriptional basic science studies in these patients.
4:08
We are trying to look at the gene pathways that may be increasing the risk in these patients with psoriatic arthritis — increased risk of cardiovascular disease — seeing what pathways, and then seeing where we can be able to intervene.
4:22
So that's the work we are currently also doing.
4:24
We did present an abstract showing some of those pathways, but we have some more work to do.
4:28
Okay. Thank you very much, Marina, for sharing your thoughts, sharing your results of the study, and we're looking forward to more data about your research.
4:38
Thank you again for joining us. Thank you, Sheila.
4:40
It was great to see you again. Yes, great seeing you too.
4:45
Thank you. This has been Sheila Reyes. Follow me on X at RheumaRampa and tune in to RheumNow for more updates of ACR 2026.
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