Evidence map›Paper›PMID 39928358›Full record

ArticleRheumatology (Oxford, England)2025

Cancer risk of Janus kinase inhibitors and biological disease-modifying antirheumatic drugs among older Americans with rheumatoid arthritis.

Shyfuddin Ahmed, Ruth M Pfeiffer, Sarah S Jackson, Minkyo Song, Xavier Mariette, Raphaèle Seror, Eric A Engels

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Lung disease in rheumatoid arthritis.Nature reviews. Rheumatology · 2026
    Review
  3. Zeitschrift fur Rheumatologie · 2026
    Article
  4. Article
  5. Review
  6. Article
  7. Review
  8. Review
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

7 authors.

Shyfuddin AhmedDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.ORCID 0000-0003-4754-6281
Ruth M PfeifferDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.ORCID 0000-0001-7791-2698
Sarah S JacksonDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.ORCID 0000-0001-6986-8842
Minkyo SongImmunoepidemiology Unit, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA.ORCID 0000-0002-9412-2871
Xavier MarietteDepartment of Rheumatology, Hôpital Bicêtre, AP-HP, Fédération Hospitalo-Universitaire CARE (Cancer and Autoimmunity Relationship), INSERM U1184, Université Paris-Saclay, Le-Kremlin-Bicêtre, France.ORCID 0000-0002-4244-5417
Raphaèle SerorDepartment of Rheumatology, Hôpital Bicêtre, AP-HP, Fédération Hospitalo-Universitaire CARE (Cancer and Autoimmunity Relationship), INSERM U1184, Université Paris-Saclay, Le-Kremlin-Bicêtre, France.ORCID 0000-0002-5523-1856
Eric A EngelsDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.ORCID 0000-0003-0203-6958

Funding

California Department of Public HealthCalifornia Health and Safety 103885CDC HHSCenters for Disease Control and Prevention'sDepartment of Public HealthNational Program of Cancer Registries 1NU58DP007156NCI NIH HHSNCI NIH HHS HHSN261201800009INCI NIH HHS HHSN261201800015INCI NIH HHS HHSN261201800032IPublic Health InstituteState of California
6 · The paper itself

Abstract

objectiveTo examine cancer risk associated with Janus kinase inhibitors (JAKis) and biological DMARDs (bDMARDs) in patients with RA.

methodsCase-control study of patients with RA age 65 years or older in the US Surveillance, Epidemiology, and End Results (SEER)-Medicare database during 2014-2019. Cases were individuals with a first cancer diagnosed in SEER registries (N = 12 463). Cancer-free controls (N = 38 345) were Medicare beneficiaries residing in SEER areas. Exposure to JAKis, tumour necrosis factor inhibitors (TNFis) and other bDMARDs was ascertained using prescription claims. Logistic regression was used to estimate adjusted odds ratios (ORs).

results1.9% of cases and 2.0% of controls were prescribed a JAKi. Among patients prescribed a JAKi, the median duration of documented exposure was 1.8 years. Overall cancer risk was not associated with exposure to JAKis (adjusted OR 1.04, 95% CI 0.87-1.26), TNFis (0.98, 0.92-1.05) or other bDMARDs (0.98, 0.90-1.07). However, JAKi exposure was associated with significantly increased risk of lung cancer (OR 1.40, 95% CI 1.06-1.87), especially in males (2.12, 1.14-3.94) and with >2 years of JAKi exposure (1.52, 1.01-2.28). Among females, JAKi exposure was associated with lower risk of breast cancer (OR 0.62, 95% CI 0.39-0.97).

conclusionsAmong older adults with RA, JAKi exposure over a median of 1.8 years was not associated with an overall increase in cancer risk. However, lung cancer risk was elevated, supporting clinical caution in prescribing this medication class to smokers. Further research is needed to understand the role of the JAK/STAT pathway in cancer.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidBiological ProductsJanus Kinase InhibitorsNeoplasmsAgedAged, 80 and overCase-Control StudiesFemaleHumansMaleMedicareRisk FactorsSEER ProgramUnited StatesAntirheumatic AgentsBiological ProductsJanus Kinase Inhibitorsbiological DMARDscancerJanus kinase inhibitorsRAtumour necrosis factor inhibitors

Identifiers

PMID39928358
PMCPMC12212909

What OpenQuestion holds

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Registered trials

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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.