Literature sharing: Which is safer for the treatment of rheumatoid arthritis, JAK inhibitor or tumor necrosis factor inhibitor?

Background and purpose

Biologic anti-rheumatic drugs (bDMARDs) have been the dominant model
for the treatment of rheumatoid arthritis (RA) since 2010.
The safety of tumor necrosis factor inhibitors (TNF inhibitors) and Janus kinase inhibitors (JAK inhibitors) in patients with RA is of concern
.
Studies aimed to evaluate the safety of
JAK inhibitors and TNF inhibitors in patients with RA.

method

The study included patients diagnosed with RA between 2015 and 2017 in the Taiwan Health Insurance Research Database and followed up until 2018
.
Propensity score stability weighting was used to balance baseline characteristics
in the JAK inhibitor and TNF inhibitor groups.
To compare the incidence of safety endpoints between study groups, namely cardiovascular (CV) events, tuberculosis (TB), total hip replacement (THR), total knee replacement (TKR), and all-cause mortality
.

outcome

1.
A total of 3179 RA patients treated with JAK inhibitors (n=822) and TNF inhibitors (n=2357) were included, and the average follow-up time of JAK inhibitor group was 2.
02 years and that of TNF inhibitor group was 2.
10 years;

2.
The incidence of all-cause death was the highest, followed by TKR, THR, CV events and TB;

3.
The incidence of safety endpoints in the JAK inhibitor group was lower than that in the TNF inhibitor group, but there was no significant difference (p->0.
05).

conclusion

In real-world RA patients, there was no significant difference
in safety profile and mortality between JAK inhibitors and TNF inhibitors.