JAK Inhibitors Cancer Risk vs DMARDs
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Core Topic: Increased malignancy risk associated with JAK inhibitors compared to biologic DMARDs in Rheumatoid Arthritis (RA) patients.
Key Findings/Points:
Higher Malignancy Risk with JAK Inhibitors: The study found a higher risk of malignancies (excluding nonmelanoma skin cancer) in patients treated with JAK inhibitors compared to those on biologic DMARDs.
Risk Factors: This increased risk was especially observed in:
Older patients
Patients with high disease activity
Study Details:
Data was derived from the German RABBIT registry, following RA patients initiating DMARD therapy between 2017-2020, followed through June 2024. The study included 2,285 patients on JAK inhibitors and 4,295 on biologic DMARDs.
88 malignancies were reported in the JAK inhibitor group, and 135 in the biologic DMARD group.
Baricitinib and Tofacitinib were the most common JAK inhibitors used.
TNF inhibitors were the most common biologic DMARDs.
Previous Research: The study acknowledges previous research (ORAL Surveillance study) that initially raised concerns about tofacitinib and malignancy risk, and notes that replicating these findings in real-world settings has been challenging. FDA/EMA Warnings: The ORAL Surveillance study prompted warnings from the FDA and EMA regarding tofacitinib use.
Infographic: An infographic is included, referencing the study by Schaefer et al. in Annals of the Rheumatic Diseases*.
Potential Summary (Short):
A study of RA patients in the German RABBIT registry found that JAK inhibitors were associated with a higher risk of malignancy compared to biologic DMARDs, particularly in older patients and those with high disease activity. These findings reinforce concerns raised by previous research and have led to warnings from regulatory agencies.Potential Summary (More Detailed):
Research using data from the German RABBIT registry indicates that JAK inhibitors may carry a higher risk of malignancy (excluding nonmelanoma skin cancer) in patients with Rheumatoid Arthritis compared to biologic DMARDs. The risk appears to be elevated in older patients and those with more active disease. This study builds on previous findings from the ORAL Surveillance study, which prompted warnings from the FDA and EMA regarding tofacitinib. The most common JAK inhibitors used in the study were baricitinib and tofacitinib, while TNF inhibitors were the most common biologic DMARDs.
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