Comparative Analysis of Coagulation Activation in Rheumatoid Arthritis Patients Treated With TNF Inhibitors Versus...

Area of Science:

• Rheumatology
• Hematology
• Pharmacology

Background:

• Rheumatoid arthritis (RA) is associated with an increased risk of venous thromboembolism (VTE).
• The coagulation system's activation in RA patients and its modulation by targeted therapies require further investigation.

Purpose of the Study:

• To investigate the activation of the coagulation system in RA patients.
• To assess changes in coagulation markers during anti-inflammatory treatment with tumor necrosis factor blockers (anti-TNF) and Janus kinase inhibitors (JAKi).

Main Methods:

• Longitudinal measurement of coagulation biomarkers (D-dimer, fibrinogen, TAT, vWF, etc.) in 83 RA patients on anti-TNF and 38 RA patients on JAKi.
• Data collection at baseline, 1, 3, and 6 months post-treatment initiation.

Main Results:

• In anti-TNF users, significant declines in D-dimer and fibrinogen were observed, with a significant increase in thrombin-antithrombin complex (TAT).
• In JAKi users, a significant decline in von Willebrand factor (vWF) was observed, with non-significant reductions in D-dimer, fibrinogen, and TAT.
• Baseline coagulation marker levels were comparable between the treatment groups.

Conclusions:

• Effective treatment with both anti-TNF and JAKi reduces the prothrombotic tendency in active RA.
• Biomarker data suggest that neither anti-TNF nor JAKi treatment is likely to increase VTE risk within the initial 6 months of therapy.