#3-32E. Real-World Cardiovascular Safety of JAK Inhibitors: The JAK-pot Collaboration (Arthritis Rheumatol, 2025)

How safe are JAK inhibitors regarding cardiovascular health in routine clinical practice? Addressing the safety concerns originally raised by the ORAL Surveillance trial, a significant new study from the international JAK-pot collaboration examined this critical question. By analyzing over 73,000 treatment courses across 15 national registries, the researchers compared the incidence of major adverse cardiovascular events (MACE) in patients with rheumatoid arthritis treating with JAK inhibitors versus TNF inhibitors. The study found no statistically significant difference in MACE rates between the two groups, with adjusted incidence rate ratios indicating comparable safety profiles. The most critical finding is that, contrary to earlier fears, real-world data suggests no increased cardiovascular risk for JAK inhibitors compared to TNF inhibitors during the first two years of therapy. However, when critically appraising this evidence, physicians must consider the relatively short median follow-up of approximately 1.5 years, which may be insufficient to capture the long-term risks that appeared after two years in randomized trials. Nevertheless, for clinicians, these findings offer valuable reassurance for patient selection and short-to-medium-term management, indicating that the immediate cardiovascular risk in general practice may be lower than previously suggested by safety trials.

Citation: Aymon, R. et al. Incidence of Major Adverse Cardiovascular Events in Patients With Rheumatoid Arthritis Treated With JAK Inhibitors Compared With Biologic Disease-Modifying Antirheumatic Drugs: Data From an International Collaboration of Registries. Arthritis & Rheumatology. 2025. DOI: 10.1002/art.43188

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