Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis
Background and Objective Janus kinase (JAK) inhibitors (JAKinibs) are effective for inflammatory bowel disease (IBD), but their cardiovascular safety is inconclusive. We aim to assess the cardiovascular risks associated with JAKinibs in IBD patients.Patients and Methods Systematic searches of seven...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2455536 |
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| author | Huibin Yang Ting An Yuxuan Zhao Xiaojing Shi Bangmao Wang Qingyu Zhang |
| author_facet | Huibin Yang Ting An Yuxuan Zhao Xiaojing Shi Bangmao Wang Qingyu Zhang |
| author_sort | Huibin Yang |
| collection | DOAJ |
| description | Background and Objective Janus kinase (JAK) inhibitors (JAKinibs) are effective for inflammatory bowel disease (IBD), but their cardiovascular safety is inconclusive. We aim to assess the cardiovascular risks associated with JAKinibs in IBD patients.Patients and Methods Systematic searches of seven databases and ClinicalTrials.gov from inception to February 2024 were conducted. Outcomes included major adverse cardiovascular events (MACE), venous thromboembolism events (VTE) and cardiovascular events (CVE), which were separately evaluated based on whether or not the dose was considered. P-score was applied to rank interventions.Results A total of 26 trials involving 10,537 IBD patients were included, and results showed no significantly increased risk of MACE, VTE and CVE was associated with JAKinibs. However, when the dose was considered, Tofacitinib 5 mg BID (versus placebo) showed a trend towards an increased risk of MACE [odds ratio (OR)=1.05, 95% confidence interval (CI): 0.23–4.82], as well as Upadacitinib 30 mg QD (versus placebo) showed a trend towards increased risks of VTE (OR=1.36, 95% CI: 0.23–8.03) and CVE (OR=1.08, 95% CI: 0.24–4.85), and ranked higher than placebo for the risk of VTE [P-score=0.766 (versus 0.722)]. Notably, Deucravacitinib ranked lowest for all cardiovascular risks, and significantly decreased the risks of VTE (OR=0.03, 95% CI: 0.00-0.87) and CVE (OR=0.03, 95% CI: 0.00-0.87) compared with placebo.Conclusions Although a trend of increased cardiovascular risks was found considering dose, no significantly increased cardiovascular risk was associated with JAKinibs in IBD patients, and Deucravacitinib significantly decreased the risks of VTE and CVE. |
| format | Article |
| id | doaj-art-5d5af17161834fba90f87d3f5c8d1d79 |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-5d5af17161834fba90f87d3f5c8d1d792025-01-22T06:20:32ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2455536Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysisHuibin Yang0Ting An1Yuxuan Zhao2Xiaojing Shi3Bangmao Wang4Qingyu Zhang5Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, ChinaBackground and Objective Janus kinase (JAK) inhibitors (JAKinibs) are effective for inflammatory bowel disease (IBD), but their cardiovascular safety is inconclusive. We aim to assess the cardiovascular risks associated with JAKinibs in IBD patients.Patients and Methods Systematic searches of seven databases and ClinicalTrials.gov from inception to February 2024 were conducted. Outcomes included major adverse cardiovascular events (MACE), venous thromboembolism events (VTE) and cardiovascular events (CVE), which were separately evaluated based on whether or not the dose was considered. P-score was applied to rank interventions.Results A total of 26 trials involving 10,537 IBD patients were included, and results showed no significantly increased risk of MACE, VTE and CVE was associated with JAKinibs. However, when the dose was considered, Tofacitinib 5 mg BID (versus placebo) showed a trend towards an increased risk of MACE [odds ratio (OR)=1.05, 95% confidence interval (CI): 0.23–4.82], as well as Upadacitinib 30 mg QD (versus placebo) showed a trend towards increased risks of VTE (OR=1.36, 95% CI: 0.23–8.03) and CVE (OR=1.08, 95% CI: 0.24–4.85), and ranked higher than placebo for the risk of VTE [P-score=0.766 (versus 0.722)]. Notably, Deucravacitinib ranked lowest for all cardiovascular risks, and significantly decreased the risks of VTE (OR=0.03, 95% CI: 0.00-0.87) and CVE (OR=0.03, 95% CI: 0.00-0.87) compared with placebo.Conclusions Although a trend of increased cardiovascular risks was found considering dose, no significantly increased cardiovascular risk was associated with JAKinibs in IBD patients, and Deucravacitinib significantly decreased the risks of VTE and CVE.https://www.tandfonline.com/doi/10.1080/07853890.2025.2455536Inflammatory bowel diseaseJanus kinase inhibitormajor adverse cardiovascular eventsnetwork meta-analysisvenous thromboembolism events |
| spellingShingle | Huibin Yang Ting An Yuxuan Zhao Xiaojing Shi Bangmao Wang Qingyu Zhang Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis Annals of Medicine Inflammatory bowel disease Janus kinase inhibitor major adverse cardiovascular events network meta-analysis venous thromboembolism events |
| title | Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis |
| title_full | Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis |
| title_fullStr | Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis |
| title_full_unstemmed | Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis |
| title_short | Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis |
| title_sort | cardiovascular safety of janus kinase inhibitors in inflammatory bowel disease a systematic review and network meta analysis |
| topic | Inflammatory bowel disease Janus kinase inhibitor major adverse cardiovascular events network meta-analysis venous thromboembolism events |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2455536 |
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