Rheumatology: Risk of severe infection in patients with rheumatoid arthritis who receive JAK inhibitors.

This systematic literature review and meta-analysis is designed to assess the risk of severe infection (SI) and shingles (HZ) in patients with rheumatoid arthritis receiving JAK inhibitors, the results of which are published online in Rheaology.
researchers conducted a systematic literature review and meta-analysis of phase II and phase III randomized controlled trials of Tofatini (5 mg bid), ballidinib (4 mg od) and Opasitini (15 mg od).
calculated the patient's exposure years.
the follow-up time of patients who received a random placebo cross-entry into the treatment arm by applying a per-programme analysis.
calculated the aggregate occurrence rate of SI and HZ per 100 people per year.
the rate ratio (IRRs) of the drug VS placebo was compared by meta-comprehensive method.
21 studies were included in the meta-analysis; 11 tofatinists (5,888 patients), 6 Baricini (3,520 patients) and 4 Erdasini studies (1,736 patients).
for SI, the rates are 1.97 (95% CI: 1.41, 2.68), 3.16 (95% CI: 2.07, 4.63) and 3.02 (95% CI:0.98, 7.04).
IRS compared to placebos was not statistically significant: 1.22 (95% CI: 0.60, 2.45), 0.80 (95% CI: 0.46, 1.38) and 1.14 (95% CI: 0.24, 5.43), respectively.
for HZ, the rates are 2.51 (95% CI: 1.87, 3.30), 3.16 (95% CI: 2.07, 4.63) and 2.41 (95% CI: 0.66, 6.18).
HZ was 2.86 (95% CI: 1.26, 6.50) compared to Ballytinib and placebo.
IR is not significant with Tofatini and upadacitinib: 1.38 (95% CI: 0.66, 2.88) and 0.78 (95% CI: 0.19, 3.22), respectively.
, which does not include HZ, is rare and does not provide a meaningful rate of occurrence.
, the results show that the absolute occurrence of SI is very low.
, the rate of HZ was higher than expected in the population (3.23/100 patient years) throughout jaK inhibitors.
although the risk of ballantinib is the highest in terms of numbers, indirect comparisons between drugs do not show any significant differences in risk.
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