Risk of Major Adverse Cardiovascular Events and Venous Thromboembolism with JAK Inhibitors versus TNF Inhibitors in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis.

Q4 Medicine
Mediterranean Journal of Rheumatology Pub Date : 2024-03-30 eCollection Date: 2024-03-01 DOI:10.31138/mjr.171023.rof
Styliani Partalidou, Dimitrios Patoulias, Kleopatra Deuteraiou, Paraskevi Avgerou, George Kitas, Maria Tzitiridou-Chatzopoulou, Theodoros Dimitroulas
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引用次数: 0

Abstract

Objective: The aim of this study was to compare the risk of major cardiovascular events (MACE) and venous thromboembolic events (VTE) between tumour necrosis factor (TNF) and Janus kinase (JAK) inhibitors in patients with rheumatoid arthritis (RA).

Methods: We researched PubMed, Scopus, Cochrane Library, and clinicaltrials.gov until December of 2023 for randomised controlled trials (RCTs) and observational studies. The outcomes studied were MACE (stroke, heart attack, myocardial infarction, sudden cardiac death) and VTE (deep vein thrombosis, pulmonary embolism). We pooled data using random effects model. Risk for the reported outcomes was expressed as odds ratio (OR) with a 95% confidential interval (CI). We performed a subgroup analysis based on study design.

Results: We identified 23 studies, 20 of which compared the odds for MACE and 14 the odds for VTE between JAK and TNF inhibitors in RA patients. Ten studies were RCTs and the rest were observational. Regarding MACE risk we pooled data from a total of 215,278 patients (52,243 were treated with JAK inhibitors, while the rest 163,035 were under TNF inhibitors). Compared with TNF inhibitors, the OR for JAK inhibitors in regards with MACE risk was 0.87 (0.64-1.17, p<0.01). Regarding VTE, a total of 176,951 patients were analysed (41,375 JAK inhibitors users and 135,576 TNF inhibitors users). The OR for VTE for JAK inhibitors compared with TNF inhibitors was 1.28 (0.89-1.84, p<0.01).

Conclusion: According to our results, there is no statistically significant difference for MACE or VTE in RA patients who receive either JAK or TNF inhibitors.

类风湿性关节炎患者使用 JAK 抑制剂和 TNF 抑制剂发生主要不良心血管事件和静脉血栓栓塞的风险:系统回顾与元分析》。
研究目的本研究旨在比较类风湿性关节炎(RA)患者服用肿瘤坏死因子(TNF)抑制剂和Janus激酶(JAK)抑制剂发生主要心血管事件(MACE)和静脉血栓栓塞事件(VTE)的风险:我们在PubMed、Scopus、Cochrane Library和clinicaltrials.gov上搜索了随机对照试验(RCT)和观察性研究,直至2023年12月。研究结果包括MACE(中风、心脏病发作、心肌梗死、心脏性猝死)和VTE(深静脉血栓、肺栓塞)。我们采用随机效应模型对数据进行了汇总。报告结果的风险以几率比(OR)和 95% 的保密区间(CI)表示。我们根据研究设计进行了亚组分析:我们确定了 23 项研究,其中 20 项研究比较了 JAK 抑制剂和 TNF 抑制剂在 RA 患者中发生 MACE 的几率,14 项研究比较了 VTE 的几率。其中 10 项为 RCT 研究,其余为观察性研究。关于MACE风险,我们汇总了215278名患者的数据(其中52243名患者接受了JAK抑制剂治疗,其余163035名患者接受了TNF抑制剂治疗)。与 TNF 抑制剂相比,JAK 抑制剂对 MACE 风险的 OR 值为 0.87(0.64-1.17,p):根据我们的研究结果,接受JAK抑制剂或TNF抑制剂治疗的RA患者在MACE或VTE方面没有明显的统计学差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.00
自引率
0.00%
发文量
42
审稿时长
8 weeks
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