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Cardiovascular and thromboembolic risks of JAK inhibitors in atopic dermatitis: A global cohort study

Khalaf Kridin1,2,3, Samer Kridin4, Eliza Mayer2,3

  • 1Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.

Journal of the European Academy of Dermatology and Venereology : JEADV
|July 21, 2025
PubMed

Insights

Janus kinase (JAK) inhibitors for atopic dermatitis (AD) show a slightly increased risk of pulmonary embolism (PE) and deep vein thrombosis (DVT) compared to dupilumab and methotrexate. Careful patient selection and thrombotic risk assessment are crucial when prescribing JAK inhibitors.

Area of Science:

  • Dermatology
  • Cardiovascular Safety
  • Pharmacovigilance

Background:

  • Janus kinase (JAK) inhibitors are increasingly prescribed for moderate-to-severe atopic dermatitis (AD).
  • Concerns exist regarding the cardiovascular safety of JAK inhibitors, specifically thromboembolic risks.
  • Real-world evidence in AD populations is limited.

Purpose of the Study:

  • To assess the real-world risk of myocardial infarction (MI), stroke, pulmonary embolism (PE), and deep vein thrombosis (DVT).
  • To compare these risks in atopic dermatitis (AD) patients treated with JAK inhibitors versus dupilumab, methotrexate, and cyclosporine.

Main Methods:

  • Utilized the TriNetX global database for a real-world, retrospective cohort study.
  • Conducted three propensity score-matched analyses comparing JAK inhibitor initiators with dupilumab, methotrexate, or cyclosporine users.
  • Assessed the incidence of MI, stroke, PE, and DVT over a 3-year follow-up period.

Main Results:

  • JAK inhibitors were associated with a significantly higher risk of PE (HR 2.75) and DVT (HR 2.54) compared to dupilumab.
  • A significantly increased risk of DVT (HR 2.41) was observed with JAK inhibitors versus methotrexate.
  • No statistically significant increase in MI or stroke risk was found for JAK inhibitors compared to any comparator.

Conclusions:

  • Atopic dermatitis (AD) patients using JAK inhibitors face a slightly elevated risk of pulmonary embolism (PE) and deep vein thrombosis (DVT) compared to those on dupilumab or methotrexate.
  • These findings highlight the importance of judicious patient selection.
  • Thrombotic risk assessment is essential prior to and during JAK inhibitor therapy for AD.
Abstract

Keywords:
JAK inhibitorsatopic dermatitiscardiovascularcyclosporinedupilumabmethotrexatethromboembolic

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