The following is a summary of “Short-Term Cardiovascular Complications in Dermatology Patients Receiving JAK-STAT Inhibitors,” published in the January 2024 issue of Dermatology by Ireland, et al.
For a study, researchers sought to assess the risk of major adverse cardiovascular events (MACE), venous thromboembolism (VTE), serious adverse events (SAEs), and tolerability of systemic Janus kinase–signal transducer and activator of transcription inhibitors (JAK-STATi) compared with placebo in patients with dermatologic indications.
A systematic literature review was conducted up to June 2023, utilizing databases including Embase, MEDLINE, SCOPUS, Cochrane Library of Registered Trials, and registered Clinical Trials. The analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines, with the analysis performed in June 2023. Placebo-controlled randomized clinical trials were included to investigate the safety of systemic JAK-STATi in patients with alopecia areata, psoriasis, vitiligo, atopic dermatitis, lichen planus, or hidradenitis suppurativa. Two researchers independently conducted study selection and data extraction using a standardized template. Crude numbers for MACE, VTE, SAEs, and study discontinuation due to treatment-emergent adverse events (TEAEs) were pooled and underwent meta-analysis. The incidence of MACE, VTE, SAEs, and study discontinuation due to TEAEs was assessed. Incidence rates (IR) were calculated against person exposure years, and risk ratios (RRs) compared incidence rates between treatment and placebo comparator arms.
About 45 randomized clinical trials were eligible, with 12,996 patients receiving active JAK-STATi therapy and 4,925 allocated to placebo. Meta-analysis revealed no significant increase in MACE (RR, 0.47; 95% CI, 0.28-0.80) or VTE (RR, 0.46; 95% CI, 0.26-0.80) between placebo and JAK-STATi comparator arms. Additionally, there was no significant difference in SAEs (RR, 0.92; 95% CI, 0.72-1.20) and discontinuations between JAK-STATi and placebo (RR, 0.94; 95% CI, 0.76-1.19).
The meta-analysis did not find a significant increase in the risk of MACE and VTE in dermatology patients receiving JAK-STATi for a median duration of 16 weeks. The findings suggested insufficient evidence to support the notion that JAK-STATi confers an elevated risk of cardiovascular complications in dermatological patients, particularly with short-term use.
Reference: jamanetwork.com/journals/jamadermatology/article-abstract/2814374