ReviewJournal of thrombosis and thrombolysis2026
Risk of venous thromboembolism with upadacitinib in rheumatoid arthritis: a meta-analysis.
Review in Journal of thrombosis and thrombolysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Upadacitinib, a selective Janus kinase (JAK) inhibitor, has become an effective therapeutic option for rheumatoid arthritis (RA). However, venous thromboembolism (VTE) represents a potentially life-threatening complication associated with JAK inhibition, and uncertainties remain regarding the risk of specific VTE subtypes with upadacitinib, including non-fatal pulmonary embolism (nPE), non-fatal deep vein thrombosis (nDVT), and concurrent pulmonary embolism and deep vein thrombosis (cPE-DVT). This meta-analysis was performed to systematically assess the risks of these individual VTE subtypes in patients with RA receiving upadacitinib relative to comparator treatments. We systematically searched databases, including PubMed, Embase, and the Cochrane Library, for relevant randomized controlled trials (RCTs) in RA patients that reported VTE and its subtypes. Meta-analysis was conducted using the Mantel-Haenszel (M-H) fixed-effects model to calculate risk ratios (RR) with 95% confidence intervals (CI) due to low heterogeneity. A total of 4 RCTs involving 4201 patients were included in this meta-analysis. The results showed that no significant differences were observed between the upadacitinib and control groups in the risk of total VTE (0.79% vs. 0.78%; RR=0.93, 95%CI: 0.47-1.83, P=0.82), nPE (0.32% vs. 0.42%; RR=0.72, 95%CI: 0.28-1.83, P=0.49), nDVT (0.34% vs. 0.33%; RR=0.97, 95%CI: 0.32-2.96, P=0.96), or cPE-DVT (0.20% vs. 0.11%; RR=1.32, 95%CI: 0.20-8.62, P=0.77). Heterogeneity was absent across all analyses (I
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