JAK-STAT Inhibitors Not Linked with Significant Increase in Cardiovascular Events

A new systematic review looking at the potential cardiovascular risks associated with Janus kinase–signal transducer and activator of transcription inhibitors (JAK-STATi) showed no safety signals in the short term. 

The findings bring a nuanced perspective on the safety profile of systemic JAK-STATi in patients with conditions such as alopecia areata, psoriasis, vitiligo, atopic dermatitis, lichen planus, or hidradenitis suppurativa. The study included 45 randomized clinical trials with a total of 12,996 patients receiving active JAK-STATi therapy (4,925 assigned to placebo) and aimed to assess the risk of major adverse cardiovascular events (MACE), venous thromboembolism (VTE), serious adverse events (SAEs), and treatment tolerability. Researchers included literature up to June 2023 using Embase, MEDLINE, SCOPUS, the Cochrane Library of Registered Trials, and registered Clinical Trials in the analysis.

The results of the review revealed no significant increase in MACE (Risk Ratio [RR], 0.47; 95% CI, 0.28 to 0.80) or VTE (RR, 0.46; 95% CI, 0.26 to 0.80) between the placebo and JAK-STATi arms. Furthermore, there were no significant differences in SAEs (RR, 0.92; 95% CI, 0.72 to 1.20) or study discontinuations due to treatment-emergent adverse events (RR, 0.94; 95% CI, 0.76 to 1.19).

"In this meta-analysis, there was no significantly increased risk of MACE and VTE in those taking JAK-STATi for a dermatologic indication, with median duration of 16 weeks. JAK-STATi were well tolerated, with no significant difference in serious adverse events and discontinuations compared with placebo," the authors wrote. "There is insufficient evidence that JAK-STATi confer an increased risk of vascular complications in dermatology patients in the short term."

Source: Ireland PA, Jansson N, Spencer SKR, Braden J, Sebaratnam D. Short-Term Cardiovascular Complications in Dermatology Patients Receiving JAK-STAT Inhibitors: A Meta-Analysis of Randomized Clinical Trials. JAMA Dermatology. Published online January 31, 2024. doi:https://doi.org/10.1001/jamadermatol.2023.5509