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Effects of Janus Kinase Inhibitors on Cardio-Vascular Risk in Rheumatic Diseases: A Prospective Pilot Study.

Diana Popescu^1,2, Minerva Codruta Badescu^1,2, Elena Rezus^3,4

¹Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania.

Journal of Clinical Medicine

|July 12, 2025

Summary

Janus kinase inhibitors (JAKi) reduced inflammation and early vascular changes like carotid intima-media thickness in autoimmune rheumatic diseases. However, elevated Lipoprotein(a) and low ankle-brachial index indicate persistent cardiovascular risk requiring monitoring.

Keywords:

Janus kinase inhibitors atherosclerosis carotid intima-media thickness lipoprotein(a)rheumatic disease rheumatoid arthritis subclinical vascular disease

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Area of Science:

Rheumatology
Cardiology
Immunology

Background:

Patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) face elevated cardiovascular risk due to chronic inflammation.
Janus kinase inhibitors (JAKi) are effective in reducing inflammation but their cardiovascular impact is not fully understood.

Purpose of the Study:

To assess JAK inhibitor therapy's effect on systemic inflammation and lipid profiles in rheumatic disease patients.
To correlate cardiovascular risk factors with biological markers and measure subclinical atherosclerosis progression.

Main Methods:

Prospective pilot study of 48 patients receiving JAK inhibitors.
Assessment of clinical, inflammatory, lipid, and vascular parameters at baseline and 12 months.
Primary endpoints: changes in carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and carotid plaque presence.

Main Results:

Significant reduction in mean cIMT and C-reactive protein (CRP) levels.
Significant decrease in Lipoprotein(a) [Lp(a)] levels; Lp(a) independently predicted carotid plaque.
Baseline ABI predicted acute cardiovascular events; carotid plaque prevalence showed a slight increase.

Conclusions:

JAK inhibitor therapy effectively reduces systemic inflammation and early vascular changes (cIMT) in autoimmune rheumatic diseases.
Residual cardiovascular risk persists in patients with low ABI and elevated Lp(a), necessitating vigilant monitoring.