No link between JAK inhibitors, venous thromboembolism in patients with atopic dermatitis

Patients with atopic dermatitis who are on Janus kinase inhibitors did not show an increased risk for venous thromboembolism, according to a study.

“Previous meta-analyses of several immune-mediated inflammatory diseases, such as psoriasis, rheumatoid arthritis, and inflammatory bowel disease, have found no significant increased risk of [venous thromboembolism (VTE)] in patients receiving treatment with JAK inhibitors,” Ching-Chi Chi, MD, MMS, DPhil, of the department of dermatology at Chang Gung Memorial Hospital in Taoyuan, Taiwan, told Healio. “However, a recent randomized clinical trial reported a 3.52-fold increased risk of VTE associated with treatment with tofacitinib for rheumatoid arthritis among patients 50 years or older who had at least one additional cardiovascular risk factor.”

A systemic review and metanalysis of two cohort studies and 15 randomized clinical trials, comprising 466,993 subjects, was completed for this study.

Of 5,722 patients with AD who were receiving JAK inhibitors, three (0.05%) developed VTE, compared with one of 3,065 patients (0.03%) of patients with AD receiving placebo or dupilumab.

For those taking JAK inhibitors, the incidence rate of VTE was 0.15 per 100 patient years, compared with 0.12 for those taking placebo.

Therefore, with an overall VTE incidence rate of 0.23 events per 100 patient years, no significant association between VTE and JAK inhibitors in patients with AD was found (HR = 0.95; 95% CI, 0.62-1.45).

“The results of this study suggest that the currently available evidence does not detect an increased risk of VTE associated with AD or treatment with JAK inhibitors. These findings may provide a valuable reference for clinicians in prescribing JAK inhibitors for patients with AD,” Chi said.