No clear link between atopic dermatitis and venous thromboembolism

There appears to be no evidence that atopic dermatitis (AD) or treatment with Janus kinase (JAK) inhibitors carries an increased risk of venous thromboembolism (VTE), according to a study.

Researchers performed a systematic review and meta-analysis of cohort studies examining the association of AD with incident VTE, as well as randomized clinical trials (RCTs) reporting VTE events in AD patients receiving JAK inhibitors. They searched multiple online databases and identified 135 articles, of which two cohort studies and 15 RCTs fulfilled the selection criteria and were included in the meta-analysis.

The total study population comprised 466,993 participants, with those included in the RCTs mostly young and middle-aged adults. Four JAK inhibitors were examined, including abrocitinib, baricitinib, upadacitinib, and SHR0302.

Pooled data, obtained using a random-effects model, revealed no significant association between AD and incident VTE (hazard ratio [HR], 0.95, 95 percent confidence interval [CI], 0.62–1.45; incidence rate of VTE, 0.23 events per 100 patient-years).

Three out of 5,722 patients with AD (0.05 percent) who were receiving treatment with JAK inhibitors experienced VTE as compared with one out of 3,065 counterparts (0.03 percent) who were receiving placebo or dupilumab (Mantel-Haenszel risk difference, 0, 95 percent CI, 0–0).

There was no significant difference in the incidence rate of VTE between AD patients on JAK inhibitors and those on placebo (0.15 vs 0.12 events per 100 patient-years, respectively). The findings were similar across the four JAK inhibitors investigated.

The findings have important implications and may guide clinicians in prescribing JAK inhibitors for patients with AD.