Cardiovascular risk and JAK inhibitor for the treatment of spondyloarthritis: A systematic review protocol

JAK inhibitors, a newer class of medications, work by blocking specific enzymes (Janus kinases) that play a key role in inflammation. By inhibiting these enzymes, JAK inhibitors help alleviate inflammation and symptoms, providing an alternative treatment option to conventional therapies like NSAIDs and biologics. Considering the lack of updated findings on cardiovascular effects in SpA patients treated with JAK inhibitors, we will perform a systematic review of the literature to investigate the safety of JAK inhibitors in SpA patients. The aim of this review is to evaluate cardiovascular safety of JAK inhibitors.

We will search multiple databases, including PubMed, Embase, and the Cochrane Library, using specific keywords such as "Janus kinase inhibitors," "JAK inhibitors," "spondyloarthritis," and "cardiac risk." Our inclusion criteria will focus on randomized controlled trials, that reports Major Adverse Cardiovascular Events (MACE), in patients treated with JAK inhibitors for spondyloarthritis. We will exclude cohort studies, and those without relevant cardiac data, as well as animal studies or those outside the scope of JAK inhibitor treatment. After screening titles and abstracts, we performed a full-text review of the selected articles to ensure the inclusion of studies with high methodological quality and relevant data on cardiac risk factors. The various stages of this literature search will be summarized using the Preferred Reporting of Systematic Reviews and Meta-Analysis (PRISMA) flow chart format to visualize the processes and findings of the review.

The preliminary results demonstrated that the existing data indicated no significant change in cardiovascular risk for JAK inhibitors-treated patients with SpA. Data analyze find no notable difference in the occurrence of MACE between the interventions and the placebo groups. These finding are to interpret with caution, given the limitations of the study numbers and duration. However, these findings provide a foundation for further investigation in this area.

This systemic review highlights the safety of JAK inhibitors according to MACE occurrence in patients with SpA when compared to placebo. These results needs to be interpreted with caution regarding the limited long-term data and small sample sizes in clinical trials. Long-term studies are needed to clarify these risks.