Relationship Between Janus Kinase Inhibitor Use and Development of Retinal Vein Occlusion

Area of Science:

• Ophthalmology
• Rheumatology
• Pharmacology

Background:

• Janus kinase (Jak) inhibitors are associated with potential thromboembolic risks.
• Comparison of Jak inhibitors versus tumor necrosis factor (TNF) inhibitors regarding ocular safety is crucial for patients with immune-mediated inflammatory diseases (IMIDs).

Purpose of the Study:

• To investigate the association between Janus kinase (Jak) inhibitor use and the risk of retinal vein occlusion (RVO) in patients with IMIDs.
• To compare the incidence of central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) between Jak inhibitor and TNF inhibitor users.

Main Methods:

• Retrospective, non-randomized cohort study utilizing a federated health research network.
• Propensity-score matched risk ratios were calculated for CRVO and BRVO.
• Cohorts included 5,249 patients treated with Jak inhibitors and 5,249 patients treated with TNF inhibitors for IMIDs.

Main Results:

• The risk ratio for CRVO with Jak inhibitors versus TNF inhibitors was 0.61 (95% CI: 0.29, 1.29).
• The risk ratio for BRVO with Jak inhibitors versus TNF inhibitors was 0.89 (95% CI: 0.47, 1.72).
• No statistically significant difference in RVO risk was observed between the two treatment groups.

Conclusions:

• This study did not find evidence of an increased risk of retinal vein occlusion (RVO) associated with Janus kinase (Jak) inhibitor use compared to tumor necrosis factor (TNF) inhibitors in patients with immune-mediated inflammatory diseases (IMIDs).
• Findings contribute to the understanding of Jak inhibitor safety profiles in ophthalmology and rheumatology.