• Jawad Bilal, Irbaz Bin Riaz, Syed Arsalan Ahmed Naqvi, Sandipan Bhattacharjee, Michelle R Obert, Maryam Sadiq, Mohamed A Abd El Aziz, Yahya Nooman, Lary J Prokop, Long Ge, Mohammad H Murad, Alan H Bryce, Robert D McBane, and C Kent Kwoh.
• Division of Rheumatology, University of Arizona, Tucson. Electronic address: jawad.bilal@hotmail.com.
• Mayo Clin. Proc. 2021 Jul 1; 96 (7): 1861-1873.

ObjectiveTo assess the risk of venous thromboembolism (VTE) in patients treated with Janus kinase (JAK) inhibitors in clinical trials.Patients And MethodsWe 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.ResultsWe 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.ConclusionWe found insufficient evidence to support an increased risk of JAK inhibitor-associated VTE based on currently available data.Copyright © 2021 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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