Getting JAKed up about deep vein thrombosis risk

Janus kinase (JAK) inhibitors have revolutionized dermatologic therapy for multiple immune disorders but are only Food and Drug Administration–approved for alopecia areata, atopic dermatitis (AD), and vitiligo. Identical box warnings—serious infections, mortality, malignancies major adverse cardiac events, and thrombosis—exist for baricitinib, ritlecitinib, upadacitinib, abrocitinib, and topical ruxolitinib. These warnings stem from the Oral Rheumatoid Arthritis Trial Surveillance study, in which enrolled patients with rheumatoid arthritis (RA) treated with tofacitinib were at least 50 years old, had active RA, were receiving methotrexate, and had at least 1 cardiovascular risk factor. The hazard ratio for deep vein thrombosis and venous thromboembolism (VTE) were up to 2.21 and 3.52, respectively, compared with those treated with a tumor necrosis factor inhibitor. 1 Ytterberg S.R. Bhatt D.L. Mikuls T.R. et al. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med. 2022; 386: 316-326https://doi.org/10.1056/NEJMoa2109927 Crossref PubMed Scopus (616) Google Scholar