PDF(Pubmed)
Abstract：
UNASSIGNED: The aim of this study was to compare the risk of major cardiovascular events (MACE) and venous thromboembolic events (VTE) between tumour necrosis factor (TNF) and Janus kinase (JAK) inhibitors in patients with rheumatoid arthritis (RA).
UNASSIGNED: We researched PubMed, Scopus, Cochrane Library, and clinicaltrials.gov until December of 2023 for randomised controlled trials (RCTs) and observational studies. The outcomes studied were MACE (stroke, heart attack, myocardial infarction, sudden cardiac death) and VTE (deep vein thrombosis, pulmonary embolism). We pooled data using random effects model. Risk for the reported outcomes was expressed as odds ratio (OR) with a 95% confidential interval (CI). We performed a subgroup analysis based on study design.
UNASSIGNED: We identified 23 studies, 20 of which compared the odds for MACE and 14 the odds for VTE between JAK and TNF inhibitors in RA patients. Ten studies were RCTs and the rest were observational. Regarding MACE risk we pooled data from a total of 215,278 patients (52,243 were treated with JAK inhibitors, while the rest 163,035 were under TNF inhibitors). Compared with TNF inhibitors, the OR for JAK inhibitors in regards with MACE risk was 0.87 (0.64-1.17, p<0.01). Regarding VTE, a total of 176,951 patients were analysed (41,375 JAK inhibitors users and 135,576 TNF inhibitors users). The OR for VTE for JAK inhibitors compared with TNF inhibitors was 1.28 (0.89-1.84, p<0.01).
UNASSIGNED: According to our results, there is no statistically significant difference for MACE or VTE in RA patients who receive either JAK or TNF inhibitors.
UNASSIGNED: We researched PubMed, Scopus, Cochrane Library, and clinicaltrials.gov until December of 2023 for randomised controlled trials (RCTs) and observational studies. The outcomes studied were MACE (stroke, heart attack, myocardial infarction, sudden cardiac death) and VTE (deep vein thrombosis, pulmonary embolism). We pooled data using random effects model. Risk for the reported outcomes was expressed as odds ratio (OR) with a 95% confidential interval (CI). We performed a subgroup analysis based on study design.
UNASSIGNED: We identified 23 studies, 20 of which compared the odds for MACE and 14 the odds for VTE between JAK and TNF inhibitors in RA patients. Ten studies were RCTs and the rest were observational. Regarding MACE risk we pooled data from a total of 215,278 patients (52,243 were treated with JAK inhibitors, while the rest 163,035 were under TNF inhibitors). Compared with TNF inhibitors, the OR for JAK inhibitors in regards with MACE risk was 0.87 (0.64-1.17, p<0.01). Regarding VTE, a total of 176,951 patients were analysed (41,375 JAK inhibitors users and 135,576 TNF inhibitors users). The OR for VTE for JAK inhibitors compared with TNF inhibitors was 1.28 (0.89-1.84, p<0.01).
UNASSIGNED: According to our results, there is no statistically significant difference for MACE or VTE in RA patients who receive either JAK or TNF inhibitors.
摘要：
■本研究的目的是比较类风湿关节炎（RA）患者肿瘤坏死因子（TNF）和Janus激酶（JAK）抑制剂之间发生主要心血管事件（MACE）和静脉血栓栓塞事件（VTE）的风险。
■我们研究了PubMed，Scopus,科克伦图书馆,和临床试验，直到2023年12月，用于随机对照试验（RCT）和观察性研究。研究的结果是MACE(卒中，心脏病发作,心肌梗塞,心源性猝死）和VTE（深静脉血栓形成，肺栓塞）。我们使用随机效应模型汇集数据。报告结果的风险表示为比值比（OR），保密区间为95％（CI）。我们根据研究设计进行了亚组分析。
■我们确定了23项研究，其中20例比较了JAK和TNF抑制剂在RA患者中MACE的几率和14例VTE的几率。10项研究为随机对照试验，其余为观察性研究。关于MACE风险，我们汇集了来自215,278例患者的数据（52,243例接受JAK抑制剂治疗，而其余163,035则在TNF抑制剂下）。与TNF抑制剂相比，JAK抑制剂在MACE风险方面的OR为0.87(0.64-1.17,p<0.01).关于VTE,共分析了176,951例患者(41,375例JAK抑制剂使用者和135,576例TNF抑制剂使用者).JAK抑制剂与TNF抑制剂相比，VTE的OR为1.28（0.89-1.84，p<0.01）。
■根据我们的结果，接受JAK或TNF抑制剂治疗的RA患者的MACE或VTE差异无统计学意义.
■我们研究了PubMed，Scopus,科克伦图书馆,和临床试验，直到2023年12月，用于随机对照试验（RCT）和观察性研究。研究的结果是MACE(卒中，心脏病发作,心肌梗塞,心源性猝死）和VTE（深静脉血栓形成，肺栓塞）。我们使用随机效应模型汇集数据。报告结果的风险表示为比值比（OR），保密区间为95％（CI）。我们根据研究设计进行了亚组分析。
■我们确定了23项研究，其中20例比较了JAK和TNF抑制剂在RA患者中MACE的几率和14例VTE的几率。10项研究为随机对照试验，其余为观察性研究。关于MACE风险，我们汇集了来自215,278例患者的数据（52,243例接受JAK抑制剂治疗，而其余163,035则在TNF抑制剂下）。与TNF抑制剂相比，JAK抑制剂在MACE风险方面的OR为0.87(0.64-1.17,p<0.01).关于VTE,共分析了176,951例患者(41,375例JAK抑制剂使用者和135,576例TNF抑制剂使用者).JAK抑制剂与TNF抑制剂相比，VTE的OR为1.28（0.89-1.84，p<0.01）。
■根据我们的结果，接受JAK或TNF抑制剂治疗的RA患者的MACE或VTE差异无统计学意义.
