(258) Risk of Incident Venous Thromboembolism Associated with Atopic Dermatitis and Treatment with Janus Kinase Inhibitors: A Systematic Review and Meta-Analysis

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 932

Presenting Author(s)

Ching-Chi Chi, MD, DPhil
– Distinguished Professor, LinKou Chang Gung Memorial Hospital, Chang Gung Memorial Hospital, Linkou, Guishan Dist, Taoyuan, Taiwan

Co-Author(s)

Tai-Li Chen
– Taipei Veterans General Hospital, Taipei, Taipei, Taiwan (Republic of China)

Background: The risk of venous thromboembolism (VTE) among patients with atopic dermatitis (AD), especially when receiving Janus kinase (JAK) inhibitors, was unclear.

Objectives: To determine the association of AD with incident VTE and to evaluate the risk of incident VTE among AD patients receiving JAK inhibitors.

Methods: We performed a systematic review and meta-analysis and searched the MEDLINE, Embase, Cochrane Library, and Web of Science databases with no restrictions on language nor geographic locations from their respective inception to February 5, 2022. We included cohort studies examining the association of AD with incident VTE and randomized controlled trials (RCTs) reporting VTE events in participants with AD receiving JAK inhibitors. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The risk of bias of included cohort studies and RCTs was assessed by the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool 2, respectively. A random-effects model meta-analysis was conducted to calculate the pooled hazard ratio (HR) for incident VTE associated with AD and risk difference for incident VTE between participants with AD receiving JAK inhibitors and controls receiving placebo or dupilumab.

Results: Two cohort studies and 15 RCTs with a total of 466,993 participants were included. The meta-analysis found no significant association of AD with incident VTE (HR 0.95, 95% CI 0.62-1.45; incidence rate of VTE: 0.23 events/100 patients-years). Overall, 3 of 5,722 AD patients receiving JAK inhibitors experienced VTE compared with 1 of 3,065 AD patients receiving placebo or dupilumab (Mantel-Haenszel risk difference, −0.00, 95% CI −0.00 to 0.00). The incidence rate of VTE was 0.15 and 0.12 events/100 patient-years in participants with AD receiving JAK inhibitors and placebo, respectively. The findings were similar in four unique JAK inhibitors (abrocitinib, baricitinib, upadacitinib, and SHR0302).

Conclusions: The currently available evidence does not detect an increased risk of VTE associated with AD or treatment with JAK inhibitors. These findings may provide a reference for clinicians in prescribing JAK inhibitors in AD patients.