Abstract | OBJECTIVES: METHOD: A systematic review and network meta-analysis was performed on randomized trials in RA patients in response to JAKi identified from Pubmed, Medline, Embase, and Cochrane Controlled Trials Register. The primary outcome was mean change of HDL-C and LDL-C from baseline. Mean treatment differences and the rank of the effect of various JAKi on HDL-C and LDL-C were estimated. RESULTS: Based on data from 18 unique studies involving five approved JAK inhibitors and 6697 RA patients (JAKi = 3341, placebo = 3356), such inhibitors led to a mean increase of 8.11 mg/dl (95% CI 6.65-9.58, I2 = 82%) in HDL levels from baseline, and a mean increase of 11.37 mg/dl (95% CI 7.84-14.91, I2 = 88%) in LDL levels from baseline. Cardiovascular disease risk did not differ significantly between patients who received JAK inhibitors or those who received placebo or active agents. CONCLUSIONS: Our analysis suggests that, at their recommended doses, all five JAK inhibitors lead to an increase in HDL and LDL levels in RA patients. Further long-term research is required to extend these results and understand whether changes in lipid levels in RA patients can affect cardiovascular risk. Key Points • This is the first systematic review and NMA examining the effect of all five clinically approved JAK inhibitors on lipid levels in RA patients. • Recommended doses of JAK inhibitors used for the treatment of RA patients can induce a significant increase in HDL and LDL levels. • Indirect pairwise comparisons suggest that only upadacitinib and peficitinib have significantly different ability to induce LDL change in RA patients.
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Authors | Na Li, Zhong-Ping Gou, Shuang-Qing Du, Xiao-Hong Zhu, Hui Lin, Xiu-Fang Liang, Yong-Sheng Wang, Ping Feng |
Journal | Clinical rheumatology
(Clin Rheumatol)
Vol. 41
Issue 3
Pg. 677-688
(Mar 2022)
ISSN: 1434-9949 [Electronic] Germany |
PMID | 34993729
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Copyright | © 2021. International League of Associations for Rheumatology (ILAR). |
Chemical References |
- Antirheumatic Agents
- Janus Kinase Inhibitors
- Lipoproteins, HDL
- Lipoproteins, LDL
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Topics |
- Antirheumatic Agents
(adverse effects)
- Arthritis, Rheumatoid
(drug therapy)
- Heart Disease Risk Factors
- Humans
- Janus Kinase Inhibitors
(adverse effects)
- Lipoproteins, HDL
(blood)
- Lipoproteins, LDL
(blood)
- Network Meta-Analysis
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