Evaluating the Usage of Janus Kinase Inhibitors in Rheumatology and Its Impact on Cardiovascular Risk

Area of Science:

• Rheumatology
• Cardiovascular Medicine
• Pharmacology

Background:

• Janus kinase (JAK) inhibitors are frequently prescribed for rheumatological conditions such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA).
• Concerns exist regarding potential cardiovascular risks, including major adverse cardiovascular events (MACE) and venous thromboembolism (VTE), associated with JAK inhibitor use.

Purpose of the Study:

• To assess the risk of MACE and VTE in patients treated with JAK inhibitors.
• To evaluate the impact of JAK inhibitors on patient lipid profiles.

Main Methods:

• Retrospective review of electronic medical records for patients aged 45-65 years.
• Analysis of data including demographics, comorbidities, medication use, laboratory results, and cardiac complications.
• Focus on patients treated with Tofacitinib, Baricitinib, or Upadacitinib.

Main Results:

• No significant VTE events were reported; one pulmonary embolism occurred in a patient with concurrent COVID-19.
• Only one case of atrial fibrillation was observed.
• A significant proportion (43%) of patients experienced worsening lipid profiles, including increased cholesterol, LDL, or triglycerides, irrespective of diabetes status.

Conclusions:

• JAK inhibitors (Tofacitinib, Baricitinib, Upadacitinib) appear to have a low risk of MACE and VTE in this patient cohort.
• A notable increase in adverse lipid profiles was observed, highlighting the need for monitoring.
• Further research is warranted to understand the long-term cardiovascular and lipid effects of JAK inhibitors in patients with rheumatological conditions.