Background and importance Alterations in the lipid profile and increased cardiovascular risk (CV) have been described in those patients treated with JAK kinase inhibitors, such as baricitinb and tofacitinib.
Aim and objectives To determine the CV risk factors and alteration of the lipid profile in patients treated with baricitinib/tofacitinib in a reference hospital.
Material and methods A retrospective, 25 month, observational study was conducted between January 2018 and February 2020 in all patients treated with tofacitinib/baricitinib. The following variables were collected: age, sex, and diagnosis and duration of treatment. In each case, the CV risk factors were analysed: obesity, smoking, high blood pressure (HTA) and diabetes mellitus (DM). To determine the appearance of hyperlipidaemia, levels of total cholesterol (TOT COL), LDL cholesterol (LDL COL) and triglycerides (TG) were analysed prior to and during the administration of tofacitinib/baricitinib. Prescription of statin-type antihyperlipaemic drugs in the electronic prescriptions was determined.
Results During the study period, 60 patients were included (71.7% women; mean age 52.9 years (24–70)). 70% were treated with tofacitinib (n=42). The classification according to diagnosis was: 81.6% (n=49) rheumatoid arthritis, 8.3% (n=5) non-rheumatoid arthritis and 10% other (n=6). Average duration of treatment was 11 months. Lipid parameters, pre versus post treatment, were the following: elevated TG levels: 13.3% (n=8) versus 31.7% (n=19); high LDL COL levels: 3.3% (n=4) versus 28.3% (n=17); and high TOT COL levels: 18.3% (n=11) versus 55% (n=33). 65% of patients (n=39) presented some CV risk factors: smoking 69.2% (n=27), HTA 46.2% (n=18), obesity 17.9% (n=7) and DM 25.6% (n=10). Of these, 43.6% (n=17) had ≥2 associated factors. 33.3% of patients (n=20) had a statin-type drug prescribed in their electronic prescription. In 70% of cases (n=14), hyperlipidaemia was observed despite the statin treatment.
Conclusion and relevance The study showed how most patients have baseline CV risk factors. The use of these drugs caused worsening of the lipid profile in more than 50% of patients, with increases in TG, LDL and total cholesterol, despite receiving lipid lowering treatment. Therefore, it is necessary to monitor this type of AE, as well as to evaluate other therapeutic alternatives to avoid possible harmful long term CV effects.
Conflict of interest No conflict of interest