#1-87E. JAK Inhibitors vs. TNF Antagonists: A Safety Showdown (JAMA Network Open, 2025)

As Janus kinase (JAK) inhibitors become more prevalent for immune-mediated inflammatory diseases, how do their safety profiles truly compare to TNF antagonists in a real-world setting? This systematic review and meta-analysis synthesizes data from 42 head-to-head comparative effectiveness studies, encompassing over 813,000 patients. The study found no significant difference in the risk of serious infections, malignant neoplasms, or major adverse cardiovascular events (MACEs) between JAK inhibitors and TNF antagonists. However, it is crucial to note that this is a meta-analysis of observational studies, and the median follow-up duration was less than two years, which may be insufficient for assessing long-term risks like malignancy. For clinicians, these findings are significant as they support the safety of JAK inhibitors in a broader patient population beyond the high-risk group in the ORAL Surveillance trial and may call for revisiting strict regulatory guidance.Citation: SOLITANO, Virginia, et al. Comparative Safety of JAK Inhibitors vs TNF Antagonists in Immune-Mediated Inflammatory Diseases: A Systematic Review and Meta-Analysis. JAMA Network Open. 2025, 8(9), e2531204. DOI: 10.1001/jamanetworkopen.2025.31204

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