Cancer risk of Janus kinase inhibitors and biological disease-modifying antirheumatic drugs among older Americans with rheumatoid arthritis.

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2025-02-10 DOI:10.1093/rheumatology/keaf092

Shyfuddin Ahmed, Ruth M Pfeiffer, Sarah S Jackson, Minkyo Song, Xavier Mariette, Raphaele Seror, Eric A Engels

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引用次数: 0

Abstract

Objective: To examine cancer risk associated with Janus kinase inhibitors (JAKis) and biological disease-modifying antirheumatic drugs (bDMARDs) in patients with rheumatoid arthritis (RA).

Methods: Case-control study of patients with RA age 65 years or older in the United States Surveillance, Epidemiology, and End Results (SEER)-Medicare database during 2014-2019. Cases were individuals with a first cancer diagnosed in SEER registries (N = 12 463). Cancer-free controls (N = 38 345) were Medicare beneficiaries residing in SEER areas. Exposure to JAKis, tumor necrosis factor inhibitors (TNFis), and other bDMARDs was ascertained using prescription claims. Logistic regression was used to estimate adjusted odds ratios (ORs).

Results: 1.9% of cases and 2.0% of controls were prescribed a JAKi. Among patients prescribed a JAKi, the median duration of documented exposure was 1.8 years. Overall cancer risk was not associated with exposure to JAKis (adjusted OR 1.04, 95% confidence interval [95%CI] 0.87-1.26), TNFis (0.98, 0.92-1.05), or other bDMARDs (0.98, 0.90-1.07). However, JAKi exposure was associated with significantly increased risk of lung cancer (OR 1.40, 95%CI 1.06-1.87), especially in males (2.12, 1.14-3.94) and with >2 years of JAKi exposure (1.52, 1.01-2.28). Among females, JAKi exposure was associated with lower risk of breast cancer (OR 0.62, 95%CI 0.39-0.97).

Conclusions: Among older adults with rheumatoid arthritis, JAKi exposure over a median of 1.8 years was not associated with an overall increase in cancer risk. However, lung cancer risk was elevated, supporting clinical caution in prescribing this medication class to smokers. Further research is needed to understand the role of the JAK/STAT pathway in cancer.

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.