Janus Kinase Inhibitors and Risk of Venous Thromboembolism: A Systematic Review and Meta-analysis

To assess the risk of venous thromboembolism (VTE) in patients treated with Janus kinase (JAK) inhibitors in clinical trials. We performed a literature search of Ovid MEDLINE and ePub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily; Ovid EMBASE; Ovid Cochrane Central Register...

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Bibliographic Details
Published in:	Mayo Clinic proceedings Vol. 96; no. 7; pp. 1861 - 1873
Main Authors:	Bilal, Jawad, Riaz, Irbaz Bin, Naqvi, Syed Arsalan Ahmed, Bhattacharjee, Sandipan, Obert, Michelle R., Sadiq, Maryam, Abd El Aziz, Mohamed A., Nomaan, Yahya, Prokop, Lary J., Ge, Long, Murad, Mohammad H., Bryce, Alan H., McBane, Robert D., Kwoh, C. Kent
Format:	Journal Article
Language:	English
Published:	England Elsevier Inc 01-07-2021 Elsevier, Inc
Subjects:	Enzyme inhibitors Risk factors Testing Venous thrombosis United States FAERS FDA R RCT OR JAK VTE TNF RA
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Summary:	To assess the risk of venous thromboembolism (VTE) in patients treated with Janus kinase (JAK) inhibitors in clinical trials. We performed a literature search of Ovid MEDLINE and ePub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily; Ovid EMBASE; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; and Scopus, from inception to December 4, 2019, for randomized, placebo-controlled trials with JAK inhibitors as an intervention and reported adverse events. Odds ratio with 95% CI was calculated to estimate the VTE risk using a random effects model. Two independent reviewers screened and extracted data. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess certainty in estimated VTE risk. We included 29 trials (13,910 patients). No statistically significant association was found between use of JAK inhibitors and risk of VTE (odds ratio, 0.91; 95% CI, 0.57 to 1.47; P=.70; I2=0; low certainty because of serious imprecision). Results using Bayesian analysis were consistent with those of the primary analysis. Results of stratified and meta-regression analyses suggested no interaction by dose of drug, indication for treatment, or length of follow-up. We found insufficient evidence to support an increased risk of JAK inhibitor–associated VTE based on currently available data.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0025-6196 1942-5546
DOI:	10.1016/j.mayocp.2020.12.035