PMID- 37080728
OWN - NLM
STAT- MEDLINE
DCOM- 20230706
LR  - 20230805
IS  - 2092-7193 (Electronic)
IS  - 2092-7193 (Linking)
VI  - 45
DP  - 2023
TI  - Risk of cancer, cardiovascular disease, thromboembolism, and mortality in 
      patients with rheumatoid arthritis receiving Janus kinase inhibitors: a 
      real-world retrospective observational study using Korean health insurance data.
PG  - e2023045
LID - 10.4178/epih.e2023045 [doi]
LID - e2023045
AB  - OBJECTIVES: This study investigated whether Janus kinase inhibitors (JAKis) raise 
      the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and 
      cancer in patients with rheumatoid arthritis (RA). METHODS: We conducted a 
      real-world retrospective observational study using data obtained from the Korean 
      National Health Insurance Service database. Two data sets were analyzed: tumor 
      necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA 
      patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and 
      hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular 
      (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial 
      thromboembolism (ATE), cancer, and all-cause mortality were compared between the 
      JAKi and TNFi groups. RESULTS: Set 1 included 1,596 RA patients (JAKi group: 645; 
      TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi 
      group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the 
      JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi 
      groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 
      (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a 
      significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 
      2.20), but the other AEs did not demonstrate increased risks in the JAKi groups. 
      CONCLUSIONS: In this study, JAKis did not increase the risk of AMI, stroke, 
      CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to 
      TNFis.
FAU - Min, Hong Ki
AU  - Min HK
AD  - Division of Rheumatology, Department of Internal Medicine, Konkuk University 
      Medical Center, Seoul, Korea.
FAU - Kim, Hyeongsu
AU  - Kim H
AD  - Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, 
      Korea.
FAU - Jeong, Ho Jin
AU  - Jeong HJ
AD  - Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, 
      Korea.
FAU - Kim, Se Hee
AU  - Kim SH
AD  - Division of Rheumatology, Department of Internal Medicine, Konkuk University 
      Medical Center, Seoul, Korea.
FAU - Kim, Hae-Rim
AU  - Kim HR
AD  - Division of Rheumatology, Department of Internal Medicine, Konkuk University 
      Medical Center, Seoul, Korea.
AD  - Research Institute of Medical Science, Konkuk University School of Medicine, 
      Seoul, Korea.
FAU - Lee, Sang-Heon
AU  - Lee SH
AD  - Division of Rheumatology, Department of Internal Medicine, Konkuk University 
      Medical Center, Seoul, Korea.
AD  - Research Institute of Medical Science, Konkuk University School of Medicine, 
      Seoul, Korea.
FAU - Lee, KunSei
AU  - Lee K
AD  - Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, 
      Korea.
FAU - Shin, Soon-Ae
AU  - Shin SA
AD  - Big Data Strategy Department, National Health Insurance Service, Wonju, Korea.
FAU - Park, Jong Heon
AU  - Park JH
AD  - Big Data Strategy Department, National Health Insurance Service, Wonju, Korea.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230415
PL  - Korea (South)
TA  - Epidemiol Health
JT  - Epidemiology and health
JID - 101519472
RN  - 0 (Janus Kinase Inhibitors)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Humans
MH  - *Janus Kinase Inhibitors/therapeutic use
MH  - *Antirheumatic Agents/adverse effects
MH  - *Cardiovascular Diseases/epidemiology
MH  - *Venous Thromboembolism/epidemiology/chemically induced/drug therapy
MH  - Tumor Necrosis Factor-alpha/therapeutic use
MH  - *Arthritis, Rheumatoid/drug therapy/chemically induced
MH  - *Myocardial Infarction/epidemiology
MH  - Insurance, Health
MH  - *Neoplasms/drug therapy
MH  - Republic of Korea/epidemiology
PMC - PMC10396807
OTO - NOTNLM
OT  - Cancer
OT  - Cardiovascular disease
OT  - Janus kinase inhibitor
OT  - Rheumatoid arthritis
OT  - Tumor necrosis factor inhibitor
OT  - Venous thromboembolism
COIS- CONFLICT OF INTEREST The authors have no conflicts of interest to declare for 
      this study.
EDAT- 2023/04/21 00:41
MHDA- 2023/07/06 06:42
PMCR- 2023/04/15
CRDT- 2023/04/20 21:08
PHST- 2022/12/15 00:00 [received]
PHST- 2023/04/05 00:00 [accepted]
PHST- 2023/07/06 06:42 [medline]
PHST- 2023/04/21 00:41 [pubmed]
PHST- 2023/04/20 21:08 [entrez]
PHST- 2023/04/15 00:00 [pmc-release]
AID - epih.e2023045 [pii]
AID - epih-45-e2023045 [pii]
AID - 10.4178/epih.e2023045 [doi]
PST - ppublish
SO  - Epidemiol Health. 2023;45:e2023045. doi: 10.4178/epih.e2023045. Epub 2023 Apr 15.