#5-21E. Navigating Cancer Risks: JAK Inhibitors in IMIDs (ARD, 2026)

When prescribing Janus kinase (JAK) inhibitors for immune-mediated inflammatory diseases (IMIDs), how should clinicians weigh the associated cancer risks? This systematic review and Bayesian network meta-analysis compares the malignancy risks of JAK inhibitors against other advanced therapies and standard care across various IMIDs. The study revealed that JAK inhibitors consistently demonstrate a higher cancer risk compared to tumor necrosis factor (TNF) inhibitors and standard care. The most crucial finding suggests that while this increased relative cancer risk is observed across different IMIDs, the absolute risk increase is highly dependent on the patient’s underlying baseline risk. However, when critically appraising this study, clinicians must consider that the short follow-up periods typical of the included randomized controlled trials might underestimate the true long-term cancer risk, as malignancy divergence often appears after extended exposure. For physicians, these findings are highly relevant; they underscore that rather than applying uniform restrictions, implementing a careful, risk-stratified approach to treatment selection is essential for optimizing patient safety and shared decision-making in daily clinical practice.

Citation: Mark Gibson, et al. Cancer risk of Janus kinase inhibitors and other advanced therapies in immune-mediated inflammatory diseases: a systematic review and Bayesian network meta-analysis of RCTs. Annals of the Rheumatic Diseases. 2026.

DOI: https://doi.org/10.1016/j.ard.2026.06.017

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