No risk of VTE in Eczema Patients Receiving JAK Inhibitors: Study

The risk of venous thromboembolism (VTE) among patients with atopic dermatitis (AD), especially when receiving treatment with Janus kinase (JAK) inhibitors, is unclear.

A study was conducted to determine the association of atopic dermatitis with incident venous thromboembolism and evaluate the risk of incident venous thromboembolism among patients with atopic dermatitis who were receiving treatment with JAK inhibitors.

Cohort studies examining the association of atopic dermatitis with incident venous thromboembolism and randomized clinical trials (RCTs) reporting venous thromboembolism events in participants with atopic dermatitis receiving JAK inhibitors were included. Around 0.7% of initially identified articles met the selection criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The risk of bias of included cohort studies and RCTs was assessed by the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool 2, respectively. A random-effects model meta-analysis was conducted to calculate the pooled hazard ratio (HR) and risk difference for incident venous thromboembolism.

Results:

• Two cohort studies and 15 RCTs with a total of 466 993 participants were included.
• The meta-analysis found no significant association of atopic dermatitis with incident venous thromboembolism
• Overall, 3 of 5722 patients with atopic dermatitis (0.05%) who were receiving treatment with JAK inhibitors experienced venous thromboembolism compared with 1 of 3065 patients with atopic dermatitis (0.03%) receiving placebo or dupilumab
• The incidence rate of venous thromboembolism was 0.15 and 0.12 events per 100 patient-years in participants with atopic dermatitis receiving JAK inhibitors and placebo, respectively.
• The findings were similar in 4 unique JAK inhibitors

Thus, the results of this systematic review and meta-analysis suggest that the currently available evidence does not detect an increased risk of venous thromboembolism associated with atopic dermatitis or treatment with JAK inhibitors. These findings may provide a reference for clinicians in prescribing JAK inhibitors for patients with atopic dermatitis.

Reference:

Chen T, Lee L, Huang H, Chen L, Loh C, Chi C. Association of Risk of Incident Venous Thromboembolism With Atopic Dermatitis and Treatment With Janus Kinase Inhibitors: A Systematic Review and Meta-analysis. JAMA Dermatol. Published online August 24, 2022. doi:10.1001/jamadermatol.2022.3516

Keywords:

Tai-Li Chen, Ling-Ling Lee, Huei-Kai Huang, Li-Yu Chen, Ching-Hui Loh, Ching-Chi Chi, JAMA Dermatology, Janus Kinase Inhibitors, Risk, Atopic Dermatitis, Association, Treatment