风险的恶性病和主要的不良心血管事件与JAK抑制剂在类风湿关节炎:一个元分析
Hongmei Duan1, Chao Jiang2, Binglun Zhang3
1Department of Rheumatology and Immunology, First Affiliated Hospital of China Medical University, Shenyang, China.
Clinical pharmacology and therapeutics
|December 22, 2025
概括
这次元分析发现,Janus激酶 (JAK) 抑制剂增加了类风湿性关节炎 (RA) 患者恶性瘤的风险. 然而,这些JAK抑制剂并没有显著改变主要不良心血管事件 (MACE) 或静脉血栓栓塞 (VTE) 的风险.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 心脏病学 心脏病学
背景情况:
- 简氏激酶 (JAK) 抑制剂越来越多地用于类风湿性关节炎 (RA) 治疗.
- 有关它们的安全性概况存在担忧,特别是恶性瘤和主要不良心血管事件 (MACE) 的风险.
研究的目的:
- 综合评估与RA患者使用JAK抑制剂相关的恶性瘤和MACE风险.
- 通过元分析综合利用的临床试验证据.
主要方法:
- 在PubMed,EMBASE和Web of Science的系统文献搜索到2025年2月7日.
- 包括18项研究,共计111,260名患者.
- 组合风险比率 (RR) 使用随机效应模型计算,并进行试验顺序分析 (TSA) 和元回归.
主要成果:
- 雅克抑制剂与整体恶性瘤 (RR=1.53) 的风险显著增加有关,包括肺癌 (RR=1.52),淋巴瘤 (RR=3.69),非小细胞肺癌 (RR=1.70),皮肤状细胞癌 (RR=2.30) 和甲状腺癌 (RR=7.51).
- 还观察到非黑色素瘤皮肤癌 (NMSC) (RR=1.54) 的显著增加.
- 在MACE (RR=0.75),静脉血栓塞栓症 (VTE) (RR=1.52) 或深静脉血栓症 (DVT) (RR=1.77) 的风险中没有发现显著变化.
结论:
- 雅克抑制剂与RA患者各种恶性瘤的风险增加有关.
- 使用JAK抑制剂似乎不会显著增加MACE,VTE或DVT的风险.
- 建议进一步进行大规模的营销后监测,以充分阐明JAK抑制剂在RA治疗中的安全性.
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