Objective:

To assess the risk of non-melanoma skin cancer (NMSC) associated with Janus kinase inhibitors (JAKi) compared to interleukin-6 receptor inhibitors (IL-6Ri) in patients with rheumatoid arthritis (RA).

Approach:

• Study Design: Data from the British Society for Rheumatology Rheumatoid Arthritis Register (BSRBR-RA) linked to National Cancer Registration and Analysis Service (NCRAS) was used. Patients with RA initiating first JAKi or IL-6Ri without prior exposure to the comparator clas…
• Analysis Method: Cox proportional hazards models estimated hazard ratios (HRs) with inverse probability of treatment weighting (IPTW) to adjust for confounding. The primary analysis excluded the first 90 days after treatment initiation.

Key Findings:

• 3,985 patients with RA were included in the primary analysis.
• 116 first-ever NMSC cases were recorded.
• The IPTW HR for JAKi vs IL-6Ri was 1.64 (95% CI: 0.85, 3.17).
• The IPTW-weighted absolute rate difference was 3.3 events per 1,000 person-years with JAKi versus IL-6Ri.

Interpretation:

The findings indicate a higher risk of NMSC with JAKi compared to IL-6Ri, although the confidence interval indicates uncertainty.

Limitations:

• The study may not account for all confounding factors.
• The analysis is based on observational data, which may introduce bias.

Conclusion:

The study indicates a potential increased risk of NMSC with JAKi in RA patients compared to IL-6Ri.

Sources:

• Article DOI