Related Experiment Video
Updated: May 10, 2025
04:05
Author Spotlight: Developing a Rat Model for Pouchitis Research and Treatment
Published on: May 31, 2024
270
Gastrointestinal Perforation as a Safety Concern Among Patients With Rheumatoid Arthritis Receiving JAK Inhibitor
Thipsukhon Sathapanasiri1, Manuel Meraz1, Hamraz Mokri2
1University of Utah, Salt Lake City.
Arthritis Care & Research
|April 21, 2025
Summary
This study found that Janus kinase inhibitors (JAKi) do not increase the risk of gastrointestinal perforation (GIP) in rheumatoid arthritis (RA) patients compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). The safety profile of JAKi regarding GIP is reassuring.
Area of Science:
- Rheumatology
- Gastroenterology
- Pharmacology
Background:
- Gastrointestinal perforation (GIP) is a serious adverse event associated with Janus kinase inhibitors (JAKi).
- Understanding the risk of GIP with JAKi in rheumatoid arthritis (RA) patients is crucial for clinical decision-making.
Purpose of the Study:
- To systematically review and meta-analyze the evidence on the risk of GIP associated with JAKi in RA patients.
- To compare the GIP risk of JAKi against other treatment options.
Main Methods:
- A comprehensive literature search was conducted across major databases for randomized controlled trials (RCTs) involving RA patients treated with JAKi.
- Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using random-effects and network meta-analysis models.
- Surface under the cumulative ranking curves (SUCRA) were used for intervention ranking.
Main Results:
- 23 RCTs with 20,023 patients were included; overall GIP incidence in JAKi users was 0.19%.
- Pairwise and network meta-analyses showed no significant increase in GIP risk for JAKi compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs).
- JAKi and biologic DMARDs demonstrated a low risk of GIP based on SUCRA.
Conclusions:
- JAK inhibitors are not associated with an increased risk of gastrointestinal perforation in rheumatoid arthritis patients when compared to csDMARDs.
- The findings suggest a favorable safety profile for JAKi concerning GIP in this patient population.
Related Concept Videos
01:22Esophageal Perforation-I: Introduction
42
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
42
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
94
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
94
01:21Inflammatory Bowel Disease V: Surgical Management
59
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
59
01:30Inflammatory Bowel Disease II: Crohn's Disease
127
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
127
01:28Esophageal Perforation-II: Clinical Manifestations and Management
24
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
24
01:20The JAK-STAT Signaling Pathway
8.4K
Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as SH2...
8.4K