JAK inhibitors don't increase risk of VTE in Atopic Dermatitis patients: JAMA

The use of JAK Inhibitors does not increase the risk of Venous thromboembolism in patients with Atopic Dermatitis as per a new study that was published in JAMA Network. 

There is not much evidence on the risk of venous thromboembolism (VTE) in patients with Atopic dermatitis (AD) under Janus kinase inhibitor treatment. Hence researchers conducted a study to find the association of AD with incident VTE and evaluate the risk of incident VTE among patients with AD who were receiving treatment with JAK inhibitors. Using keywords without any language or geographical restrictions, MEDLINE, Embase, Cochrane Library, and Web of Science databases were searched from the inception to February 5, 2022. Cohort studies that find the association of AD with incident VTE and randomized clinical trials (RCTs) that report VTE events in patients receiving JAK inhibitors were included. Of these only 0.7% of initially identified articles met the selection criteria. PRISMA guidelines were followed, and the risk of bias was assessed in included cohort studies, and RCTs by the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool 2, respectively. Pooled hazard ratio (HR) and risk difference for incident VTE was calculated using the random-effects model meta-analysis. 

Results: 

• Two cohort studies and 15 RCTs with a total of 4,66,993 participants were included.
• The meta-analysis found no significant association of AD with incident VTE.
• Overall, 3 of 5722 patients with AD (0.05%) who were receiving treatment with JAK inhibitors experienced VTE compared with 1 of 3065 patients with AD (0.03%) receiving placebo or dupilumab.
• The incidence rate of VTE was 0.15 and 0.12 events per 100 patient-years in participants with AD receiving JAK inhibitors and placebo, respectively.
• The findings were similar in 4 unique JAK inhibitors. 

Thus, the researchers concluded in this study that there is no increased risk of VTE associated with AD or treatment with JAK inhibitors. They further suggested that clinicians may prescribe JAK inhibitors for patients with AD. 

For the full article, click here: 10.1001/jamadermatol.2022.3516 

Chen TL, Lee LL, Huang HK, Chen LY, Loh CH, Chi CC. Association of Risk of Incident Venous Thromboembolism With Atopic Dermatitis and Treatment With Janus Kinase Inhibitors. JAMA Dermatology. Published online August 24, 2022. doi:10.1001/jamadermatol.2022.3516