Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data
OBJECTIVES This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA). METHODS We conducted a real-world retrospective observational study using data obtained from...
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| Format: | Article |
| Language: | English |
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Korean Society of Epidemiology
2023-04-01
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| Series: | Epidemiology and Health |
| Subjects: | |
| Online Access: | http://www.e-epih.org/upload/epih-45-e2023045.pdf |
| _version_ | 1797305333154054144 |
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| author | Hong Ki Min Hyeongsu Kim Ho Jin Jeong Se Hee Kim Hae-Rim Kim Sang-Heon Lee KunSei Lee Soon-Ae Shin Jong Heon Park |
| author_facet | Hong Ki Min Hyeongsu Kim Ho Jin Jeong Se Hee Kim Hae-Rim Kim Sang-Heon Lee KunSei Lee Soon-Ae Shin Jong Heon Park |
| author_sort | Hong Ki Min |
| collection | DOAJ |
| description | OBJECTIVES This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA). METHODS We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups. RESULTS Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups. CONCLUSIONS In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis. |
| first_indexed | 2024-03-08T00:24:24Z |
| format | Article |
| id | doaj.art-f678869c50ba4abc8bb7d5773eda7aa1 |
| institution | Directory Open Access Journal |
| issn | 2092-7193 |
| language | English |
| last_indexed | 2024-03-08T00:24:24Z |
| publishDate | 2023-04-01 |
| publisher | Korean Society of Epidemiology |
| record_format | Article |
| series | Epidemiology and Health |
| spelling | doaj.art-f678869c50ba4abc8bb7d5773eda7aa12024-02-16T01:04:24ZengKorean Society of EpidemiologyEpidemiology and Health2092-71932023-04-014510.4178/epih.e20230451407Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance dataHong Ki Min0Hyeongsu Kim1Ho Jin Jeong2Se Hee Kim3Hae-Rim Kim4Sang-Heon Lee5KunSei Lee6Soon-Ae Shin7Jong Heon Park8 Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea Big Data Strategy Department, National Health Insurance Service, Wonju, Korea Big Data Strategy Department, National Health Insurance Service, Wonju, KoreaOBJECTIVES This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA). METHODS We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups. RESULTS Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups. CONCLUSIONS In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.http://www.e-epih.org/upload/epih-45-e2023045.pdfrheumatoid arthritiscardiovascular diseasevenous thromboembolismcancerjanus kinase inhibitortumor necrosis factor inhibitor |
| spellingShingle | Hong Ki Min Hyeongsu Kim Ho Jin Jeong Se Hee Kim Hae-Rim Kim Sang-Heon Lee KunSei Lee Soon-Ae Shin Jong Heon Park Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data Epidemiology and Health rheumatoid arthritis cardiovascular disease venous thromboembolism cancer janus kinase inhibitor tumor necrosis factor inhibitor |
| title | Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data |
| title_full | Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data |
| title_fullStr | Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data |
| title_full_unstemmed | Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data |
| title_short | Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data |
| title_sort | risk of cancer cardiovascular disease thromboembolism and mortality in patients with rheumatoid arthritis receiving janus kinase inhibitors a real world retrospective observational study using korean health insurance data |
| topic | rheumatoid arthritis cardiovascular disease venous thromboembolism cancer janus kinase inhibitor tumor necrosis factor inhibitor |
| url | http://www.e-epih.org/upload/epih-45-e2023045.pdf |
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