IN patients with rheumatoid arthritis (RA), understanding the risk of venous thromboembolism (VTE) is increasingly important as treatment strategies evolve. A recent cross-sectional study explored which clinical and disease-related factors are independently associated with VTE in RA, uncovering several notable associations, including a strong link with JAK inhibitor use.
Conducted over a 24-month period at a single center, the study analyzed data from 469 consecutive RA patients, 81% of whom were women, with a mean age of 59 years. Investigators focused on VTE events that occurred after 2018, the year JAK inhibitors (JAKi) became available in France, using electronic medical records to track patient characteristics and relevant comorbidities.
Of the 469 patients, 15 experienced a VTE (3%) after 2018. The average time between VTE and clinical assessment was 4.5 months. The most powerful predictor of VTE was a history of prior VTE, which carried an odds ratio (OR) of 44.74 (95% CI 8.83–226.68). However, other significant and independent risk factors also emerged. Recent hospitalization within three months prior to the event (OR 6.82, 95% CI 1.60–29.11) and diabetes (OR 11.23, 95% CI 2.21–57.01) were both strongly associated with the development of VTE.
Among RA treatments, JAK inhibitors showed a significant association with VTE, with an OR of 5.54 (95% CI 1.03–29.72). The findings reinforce current safety recommendations that urge caution when prescribing JAK inhibitors to patients with known VTE risk factors.
This study highlights the multifactorial nature of thromboembolic risk in RA, emphasizing the need to carefully evaluate individual cardiovascular profiles, including diabetes and recent hospitalization history, before initiating therapies known to affect thrombotic risk. These insights align with existing guidance from regulatory bodies and professional societies urging vigilance in patient selection for JAKi use.
Reference:
Rouzaud A. Risk factors associated with venous thromboembolism in rheumatoid arthritis in clinical practice. RMD Open. 2024;10:e003432.
