JAK Inhibitors Raise Venous Thromboembolism Risk in AD

TOPLINE:

JAK inhibitors demonstrated significantly higher risk for venous thromboembolism than dupilumab and methotrexate in patients with atopic dermatitis (AD) in a retrospective study.

METHODOLOGY:

• Researchers conducted three propensity score-matched analyses comparing patients with AD initiating JAK inhibitors with those receiving dupilumab (n = 1006), methotrexate (n = 958), or cyclosporine (n = 948) from the TriNetX global database.
• The mean patient age was 41.7-43.3 years; about 62% were women; 54% were White individuals, and 46% were non-White individuals across the groups.
• Study outcomes were the incidence of myocardial infarction (MI), stroke, pulmonary embolism (PE), and deep vein thrombosis (DVT) within 3 years of treatment initiation.

TAKEAWAY:

• Among patients treated with JAK inhibitors, the risks for PE (hazard ratio [HR], 2.75; P = .014) and DVT (HR, 2.54; P = .017) were significantly higher, corresponding to eight and nine additional cases per 1000 patients (risk differences of 0.8% and 0.9%), respectively. The overall risk for stroke was comparable in the two groups.
• JAK inhibitors were associated with a higher risk for DVT (HR, 2.41; P = .017) than methotrexate, corresponding to seven additional cases per 1000 patients (risk difference of 0.7%). The risks for PE, MI, and stroke were similar in the two groups.
• Compared with cyclosporin, the researchers noted no significant differences in the 3-year risk for PE, DVT, stroke, or MI.

IN PRACTICE:

Based on the results, “patients with AD initiating JAK inhibitors are at an elevated risk of PE and DVT as compared to those managed by dupilumab,” and JAK inhibitors “were associated with an increased risk of DVT as compared to methotrexate,” the authors of the study wrote. These results, they concluded, “support a cautious, individualized approach to the use of JAK inhibitors, particularly in patients with elevated baseline thromboembolic risk.”

SOURCE:

The study was led by Khalaf Kridin, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany, and was published online on July 21 in the Journal of the European Academy of Dermatology and Venereology.

LIMITATIONS:

The study used retrospective observational data, and JAK inhibitors were analyzed as a class, not by individual drug or dose. 

DISCLOSURES:

The study did not receive any funding, and the authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.