Evidence map›Paper›PMID 37996125›Full record

Observational studyRMD open2023

Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis.

Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Johan Askling

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Hannah BowerClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden hannah.bower@ki.se.ORCID 0000-0002-2046-3833
Thomas FrisellClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-5735-9626
Daniela di GiuseppeClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-3817-8288
Benedicte DelcoigneClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-2716-5679
Johan AsklingClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-0433-0616
Karolinska Institutet · SEKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the incidence of cardiovascular (CV) events in rheumatoid arthritis (RA) treated with janus kinase inhibitors (JAKi), tumour necrosis factor inhibitors (TNFi), or other biological disease-modifying antirheumatic drugs (bDMARDs), in clinical practice, and to contextualise these findings by comparing to the Swedish RA population and general population at large.

methodsPatients with RA initiating JAKi, TNFi and non-TNFi bDMARDs were identified in the Swedish Rheumatology Quality Register between 2016 and 2021. Through linkages to national registers, a cohort of patients with RA, general population comparators, as well as covariates and incident major acute CV event (MACE, including myocardial infarction, stroke and fatal CV events) were identified until 2022. Crude and age-sex standardised rates were calculated and HRs estimated from multivariable Cox regression models using TNFi as reference.

resultsWe identified 13 492 patients with RA initiating a JAKi, non-TNFi bDMARD or TNFi treatment. Among 3037 JAKi-initiators, 59 MACE events were observed. The age-sex standardised rates for MACE were similar in the JAKi (0.88 per 100 person years) and TNFi (0.91) cohorts. Fully adjusted models showed no increased rate of MACE with JAKi (HR=0.71, 95% CI 0.51 to 0.99), or non-TNFi bDMARD (HR=0.98; 95% CI 0.78 to 1.23) in comparison to TNFi. We found no evidence that this HR changed over time since treatment initiation. In a CV-enriched subset, we observed higher rates but similar HRs.

conclusionsAs used in present clinical practice in Sweden, we found no evidence that CV risk is higher with JAKis than TNFis in RA.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidJanus Kinase InhibitorsCohort StudiesHumansSwedenAntirheumatic AgentsJanus Kinase InhibitorsBiological TherapyCardiovascular DiseasesEpidemiologyRheumatoid Arthritis

Identifiers

PMID37996125
PMCPMC10668277
OpenAlexW4388947809

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.