MACE and VTE across Upadacitinib Clinical Trial Programmes in Rheumatoid Arthritis, Psoriatic Arthritis and Ankylosing Spondylitis
RMD Open 2023; 9(4):e003392 doi 10.1136/rmdopen-2023-003392
Rates of MACE and VTE events in patients with RA or PsA treated are consistent across 15 mg and 30 mg doses of upadacitinib, and comparable with active comparators adalimumab and MTX. Several risk factors were also identified for MACE and VTE events in patients with RA.
Risk of Major Adverse Cardiovascular Events in Immune-Mediated Inflammatory Disorders on Biologics and Small Molecules: Network Meta-Analysis
Clin Gastroenterol Hepatol. 2023 Oct 9:S1542-3565(23)00767-X doi 10.1016/j.cgh.2023.09.033 Epub ahead of print
The results of this study show that anti-IL-12/23, JAK inhibitors, and anti-TNF-α were associated with slightly higher risk of MACE compared with placebo. The risk was no different between biologic treatments, and the magnitude of risk did not differ between IMID type.
Risk of Major Adverse Cardiovascular Events in Patients with Rheumatoid Arthritis Treated with Conventional Synthetic, Biologic and Targeted Synthetic Disease-modifying Antirheumatic Drugs: Observational Data from the German RABBIT Register
RMD Open 2023;9:e003489 doi 10.1136/rmdopen-2023-003489
This study by Meissner, et al. estimated the effects of JAKi, TNFi, bDMARDs and csDMARDs on the risk of MACE in RA patients. The authors found no significant difference in MACE risk by treatment group, even among patients at increased CV risk.
Cardiovascular Safety of Janus Kinase Inhibitors in Patients with Rheumatoid Arthritis: Systematic Review and Network Meta-analysis
Front Pharmacol. 2023; 8(14):1237234 doi 10.3389/fphar.2023.1237234
This meta-analysis by Wei, et al. found that JAKi therapy was not associated with a higher risk of MACE than treatment with adalimumab, abatacept, or placebo. However, a higher incidence of all-cause mortality was observed with tofacitinib treatment than with adalimumab treatment.
Relationship Between Paraoxonase-1 Genotype and Activity, and Major Adverse Cardiovascular Events and Malignancies in Patients with Rheumatoid Arthritis Receiving Tofacitinib
J Rheumatol. 2023 doi 10.3899/jrheum.2023-0112 Epub ahead of print
High paraoxonase activity is associated with a significantly reduced risk of MACE and non-NMSC malignancies in white/European RA patients. The PON1 Q192R RR genotype had a significantly greater association with paraoxonase versus the QQ genotype, but had no significant association with MACE or non-NMSC malignancies.
Association Between Baseline Cardiovascular Risk and Incidence Rates of Major Adverse Cardiovascular Events and Malignancies in Patients with Psoriatic Arthritis and Psoriasis Receiving Tofacitinib
Ther Adv Musculoskelet Dis. 2023 doi: 10.1177/1759720X221149965
Baseline 10-year atherosclerotic cardiovascular disease risk and metabolic syndrome are potentially associated with the incidence of both MACE and malignancies in patients receiving TOFA in the PsA and PsO clinical trial programs. This post hoc analysis aimed to examine the baseline CV disease risk and its association with the occurrence of MACE and malignancies in TOFA-treated patients with PsA and PsO.
Impact of NSAIDs on 8-year Cumulative Incidence of Major Cardiovascular Events in Patients with Ankylosing Spondylitis: A Nationwide Study
Rheumatology (Oxford). 2023 doi: 10.1093/rheumatology/kead072
MACEs were observed in patients newly receiving compensation from the Long-term Illness Scheme for AS. The objective of this study was to describe the incidence of MACEs in French patients newly benefiting from the French LTI for AS. The study also sought to evaluate the effect of various treatments on the risk of MACE occurrence.
Baricitinib Safety for Events of Special Interest in Populations at Risk: Analysis from Randomised Trial Data Across Rheumatologic and Dermatologic Indications
Adv Ther. 2023;40(4):1867–1883 doi: 10.1007/s12325-023-02445-w
Analysis of pooled data from the baricitinib clinical development programmes finds a low incidence rate of MACE, myocardial infarction, lung cancer, VTE, and overall mortality in patients <65 years without risk factors.
Impact of Cardiovascular Risk Enrichment on Incidence of Major Adverse Cardiovascular Events in the Tofacitinib Rheumatoid Arthritis Clinical Programme
Ann Rheum Dis. 2023;82(4):575–577 doi: 10.1136/ard-2022-223406
Data suggest that an important difference between P123LTE and ORAL Surveillance was the proportion of patients with a history of atherosclerotic CV disease (ASCVD).
Evaluation of VTE, MACE, and Serious Infections Among Patients with RA Treated with Baricitinib Compared to TNFi: A Multi-Database Study of Patients in Routine Care Using Disease Registries and Claims Databases
Rheumatol Ther. 2022. Epub ahead of print doi: 10.1007/s40744-022-00505-1
Salinas, et al. evaluate baricitinib safety with respect to VTE, MACE, and serious infection relative to TNFi in patients with RA, in routine care and observe an increased risk of VTE in patients taking baricitinib, compared to TNFi.