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

Jawad Bilal, Irbaz Bin Riaz, Syed Arsalan Ahmed Naqvi, Sandipan Bhattacharjee, Michelle R. Obert, Maryam Sadiq, Mohammad A. Abd El Aziz, Yahya Nooman, Lary J. Prokop, Long Ge, Mohammad H. Murad, Alan H. Bryce, Robert D. McBane, C. Kent Kwoh

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess the risk of venous thromboembolism (VTE) in patients treated with Janus kinase (JAK) inhibitors in clinical trials. Patients and Methods: 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. Results: 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. Conclusion: We found insufficient evidence to support an increased risk of JAK inhibitor–associated VTE based on currently available data.

Original languageEnglish (US)
JournalMayo Clinic Proceedings
DOIs
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Medicine(all)

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