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. 2022 Aug 24;158(11):1254–1261. doi: 10.1001/jamadermatol.2022.3516

Association of Risk of Incident Venous Thromboembolism With Atopic Dermatitis and Treatment With Janus Kinase Inhibitors

A Systematic Review and Meta-analysis

Tai-Li Chen 1,2, Ling-Ling Lee 3, Huei-Kai Huang 4,5, Li-Yu Chen 6, Ching-Hui Loh 2,7, Ching-Chi Chi 8,9,✉
PMCID: PMC9403856  PMID: 36001310

Key Points

Question

Do patients with atopic dermatitis (AD), particularly those receiving treatment with Janus kinase (JAK) inhibitors, have an increased risk for venous thromboembolism (VTE)?

Findings

This systematic review and meta-analysis included 2 cohort studies and 15 randomized clinical trials with 466 993 participants. The analysis found no significant association of AD with incident VTE nor an increased risk of incident VTE among participants with AD who were receiving JAK inhibitors.

Meaning

The study results indicate that the evidence to date is insufficient to determine a significant association of AD with VTE and support the current warning of VTE being associated with JAK inhibitors in treating AD; future real-world long-term data are warranted.

Abstract

Importance

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

Objective

To determine the association of AD with incident VTE and evaluate the risk of incident VTE among patients with AD who were receiving treatment with JAK inhibitors.

Data Sources

The MEDLINE, Embase, Cochrane Library, and Web of Science databases were searched with no restrictions on language nor geographic locations from their respective inception to February 5, 2022.

Study Selection

Cohort studies examining the association of AD with incident VTE and randomized clinical trials (RCTs) reporting VTE events in participants with AD receiving JAK inhibitors were included. Around 0.7% of initially identified articles met the selection criteria.

Data Extraction and Synthesis

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) and risk difference for incident VTE.

Main Outcomes and Measures

The HRs for incident VTE associated with AD and risk difference for incident VTE between participants with AD who were receiving treatment with 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 patient-years). Overall, 3 of 5722 patients with AD (0.05%) who were receiving treatment with JAK inhibitors experienced VTE compared with 1 of 3065 patients with AD (0.03%) receiving placebo or dupilumab (Mantel-Haenszel risk difference, 0; 95% CI, 0-0). The incidence rate of VTE was 0.15 and 0.12 events per 100 patient-years in participants with AD receiving JAK inhibitors and placebo, respectively. The findings were similar in 4 unique JAK inhibitors (abrocitinib, baricitinib, upadacitinib, and SHR0302).

Conclusions and Relevance

The results of this systematic review and meta-analysis suggest that 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 for patients with AD.

This systematic review and meta-analysis examines the risk of incident venous thromboembolism among patients with atopic dermatitis who were receiving treatment with Janus kinase inhibitors.

Introduction

Atopic dermatitis (AD) is a prevalent inflammatory dermatosis with increasing worldwide prevalence.1,2 Symptoms, such as relapsing pruritus and visible lesions, may last for a few years and even persist throughout life, necessitating effective treatments.3,4 Janus kinase (JAK) inhibitors have become a promising treatment option for patients with AD because they have been associated with favorable clinical outcomes in clinical trials.5

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a potentially life-threatening illness associated with high recurrence rates and mortality.6,7 While several studies have investigated the potential associations of AD with VTE, the results were inconsistent.8,9 Because the US Food and Drug Administration issued a black box warning about an increased risk of blood clots for tofacitinib, baricitinib, and upadacitinib in treating arthritis and other chronic inflammatory conditions, concerns have been raised regarding the risk of VTE being associated with JAK inhibitor therapy.10 Previous meta-analyses regarding several immune-mediated inflammatory diseases, such as psoriasis, rheumatoid arthritis, and inflammatory bowel disease, have found no significant increased risk of VTE in patients receiving treatment with JAK inhibitors.11,12 However, a recent randomized clinical trial reported a 3.52-fold increased risk of VTE associated with treatment with tofacitinib, 10 mg, twice daily, for rheumatoid arthritis among patients 50 years or older who had at least 1 additional cardiovascular risk factor.13 Although JAK inhibitors have been approved in treating AD over recent years, to our knowledge, there has been no systematic evaluation of the risk of VTE among patients with AD and the corresponding safety profile of JAK inhibitors in treating AD. To address this knowledge gap, this systematic review and meta-analysis aimed to evaluate the current evidence on the association of AD with incident VTE and the risk of incident VTE in patients with AD who were receiving treatment with JAK inhibitors.

Methods

This systematic review and meta-analysis followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE)14 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.15 The prespecified study protocol was registered with PROSPERO (CRD42022307784). The study was granted an exemption from institutional review board approval from the Chang Gung Medical Foundation.

Data Sources and Evidence Search

A comprehensive literature search was performed on electronic databases (including MEDLINE, Embase, Cochrane Library, and Web of Science) from their respective inception to February 5, 2022. The search strategy was designed with the assistance of an experienced librarian (L.C.) (eTable in the Supplement). There were neither language nor geographic limitations. The references of eligible studies and relevant reviews were also manually scrutinized for additional studies.

Eligibility Criteria

To investigate the association of AD with incident VTE, we first included studies that met the following criteria: (1) cohort studies examining the association of AD with incident VTE; (2) an exposure group comprising individuals with AD and a nonexposure control group comprising people without AD; (3) reporting the risk estimates of incident VTE. We only included cohort studies to reduce recall bias and examine the temporal association between AD and incident VTE.

To further evaluate the risk of VTE in patients with AD who were treated with JAK inhibitors, we included studies that fulfilled the following criteria: (1) phase 2 and phase 3 randomized clinical trials (RCTs) investigating the safety of JAK inhibitors for patients with AD; (2) an intervention group comprising participants with AD receiving treatment with JAK inhibitors and a control group comprising participants with AD receiving either placebo or dupilumab; (3) reporting the number of VTE events. Open-label or long-term extension studies without a control arm were excluded. Studies with patients using topical JAK inhibitors (eg, delgocitinib, ruxolitinib, and tofacitinib) were also excluded.

When multiple studies presented results from the same database or RCT, we only included the one with the most comprehensive data. We only included studies with confirmed diagnoses of AD and VTE by validated diagnostic codes or clinical criteria. Review articles, editorials, case reports, cross-sectional studies, case-control studies, and studies with nonhuman participants were excluded. Two independent authors (T.C. and L.L.) selected studies by screening the titles and abstracts of the initial literature search. The full text of potentially relevant publications was retrieved for confirming eligibility. Disagreements were resolved through discussion with 2 senior authors (H.H. and C.C.) until reaching consensus.

Data Extraction and Risk of Bias Assessment

Two authors (T.C. and L.L.) independently collated the following data using a standardized data sheet: first author, year of publication, country, database or clinical trial identifier, study period, patient characteristics (sample size, age, and sex), definition of AD, and outcomes of interest (risk estimates or the number of VTE events). For the included cohort studies, we extracted the adjusted hazard ratio (HR) with 95% CIs. The risk estimates with the most appropriate adjustment for confounders, such as age, sex, and comorbidities, were used for data synthesis. For the included RCTs, we extracted the number of VTE events. Both DVT and PE were considered VTE events. For studies that did not report sufficient information for meta-analysis, we contacted the corresponding authors for additional data.

The risk of bias of included cohort studies was assessed using the Newcastle-Ottawa Scale,16 whereas that of RCTs was appraised using the Cochrane risk of bias tool (RoB 2).17 Two authors (T.C. and L.L.) independently performed the risk of bias assessment. Any discrepancy in the extracted data and risk of bias assessment was resolved by discussion with senior authors (H.H. and C.C.).

Statistical Analysis

We used Review Manager, version 5.4.1 (The Cochrane Collaboration, 2020) to conduct meta-analyses.18 Two meta-analyses were separately performed for cohort studies (the association of AD with incident VTE) and RCTs (the risk of incident VTE among patients with AD who were receiving treatment with JAK inhibitors). A P value of <.05 was deemed significant. The pooled HRs and corresponding CIs were synthesized to determine the association of AD with incident VTE. Absolute risk differences were used to measure the risk of incident VTE in patients receiving treatment with various JAK inhibitors when compared with those using placebo or dupilumab.19 The random-effects model was applied for meta-analyses based on the assumption of considerable clinical heterogeneity.20 For RCTs with 0 events of VTE reported in both arms, a fixed value of 0.5 was added to correct for computational errors.18 Heterogeneity between individual studies was quantified using the I2 statistics, with an I2 of greater than 50% indicating at least moderate heterogeneity. Publication bias was evaluated by inspecting funnel plots if there were 10 or more studies for an outcome.

Results

Selection of Studies

The PRISMA study flow diagrams for the cohort study and RCT selection are illustrated in Figure 1. A total of 2370 citations were obtained from the initial database search. After removal of duplicates and screening of titles and abstracts, the full text of 135 records was assessed for eligibility (25 studies [18.5%] and 110 studies [81.5%] in the selection of cohort studies and RCTs, respectively). Eventually, we included 2 cohort studies21,22 and 15 RCTs23,24,25,26,27,28,29,30,31,32,33,34,35,36,37 with a total of 466 993 participants. Only 0.7% of initially identified studies fulfilled the selection criteria.

Figure 1. PRISMA Flow Diagrams for the Selection of Cohort Studies and Randomized Clinical Trials.

Figure 1.

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AD indicates atopic dermatitis; VTE, venous thromboembolism.

Characteristics of Included Studies

Table 121,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37 outlines the characteristics of the included studies. The two cohort studies were conducted in the US, whereas most RCTs were conducted across multiple countries. The definition of AD in cohort studies was based on validated International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes.38 The diagnosis of AD in RCTs was based on the Hanifin and Rajka criteria,39 diagnostic criteria proposed by the American Academy of Dermatology,40 and Chinese criteria.41 The participants in the included RCTs were primarily young and middle-aged adults; however, the study by Eichenfield et al26 included mainly adolescents. Four JAK inhibitors (abrocitinib, baricitinib, upadacitinib, and SHR0302) were investigated.

Table 1. Characteristics of Included Studies.

Source Cohort studies
Database Study period No. of participants, AD/non-AD Age, mean (SD), y Sex, female % Definition of AD VTE, HRs (95% CI) VTE incidence rates per 100 patient-years
Meyers et al,21 2021 IBM MarketScan Commercial Claims and Encounters, Medicare Supplemental, and Medicaid databases 2012-2017 198 685/198 685 46.0 (17.0) 65.2 ICD-9 code 691.8 or ICD-10 code L20.0, L20.8x, L20.9 0.77 (0.69-0.85) 0.24
Schneeweiss et al,22 2021 Optum’s deidentified Clinformatics Data Mart Database 2004-2019 30 418/30 418 47.5 (18.0) 60.8 ICD-9 code 691.8 or ICD-10 code L20, L20.82, L20.84 1.19 (0.95-1.48) 0.18
Source Randomized clinical trials
Clinical trial identifier JAK inhibitor No. of patients with AD, intervention group/control group Age, mean (SD), y Sex, female % Definition of AD Placebo-controlled phase, weeks
Bieber et al,23 2021 NCT03720470 (JADE COMPARE) Abrocitinib 464/131 38.0 (14.7) 51.7 Hanifin and Rajka criteria 12
Blauvelt et al,24 2021 NCT03738397 (Heads up) Upadacitinib 348/344 36.6 (14.6) 47.4 Hanifin and Rajka criteria 24
Blauvelt et al,24 2022 NCT03627767 (JADE REGIMEN) Abrocitinib 531/267 Median (IQR), 29.0 (20-41) 43.9 Hanifin and Rajka criteria 40
Eichenfield et al,26 2021 NCT03796676 (JADE TEEN) Abrocitinib 189/96 Median (IQR), 16.0 (14-17) 46.6 Hanifin and Rajka criteria 12
Gooderham et al,27 2019 NCT02780167 Abrocitinib 211/56 40.4 (16.3) 51.7 Hanifin and Rajka criteria 12
Guttman-Yassky et al,28 2020 NCT02925117 Upadacitinib 126/40 40.0 (15.3) 36.5 Hanifin and Rajka criteria 16
Guttman-Yassky et al,29 2021 NCT03569293 (Measure Up 1) and NCT03607422 (Measure Up 2) Upadacitinib 1124/559 Median (IQR), 33.8 (12-75) 44.0 Hanifin and Rajka criteria 16
Katoh et al,30 2022 NCT03661138 (Rising Up) Upadacitinib 182/90 35.5 (13.0) 24.7 Hanifin and Rajka criteria 24
Reich et al,31 2020 NCT03733301 (BREEZE-AD7) Baricitinib 220/108 33.9 (12.1) 34.1 Diagnostic criteria proposed by AAD guideline 16
Reich et al,32 2021 NCT03568318 (AD Up) Upadacitinib 597/303 Median (IQR), 34.0 (12-74) 38.2 Hanifin and Rajka criteria 16
Silverberg et al,33 2020 NCT03575871 (JADE MONO-2) Abrocitinib 313/78 35.5 (15.3) 41.9 Hanifin and Rajka criteria 12
Simpson et al,34 2020 NCT03349060 (JADE MONO-1) Abrocitinib 310/77 32.8 (16.4) 44.8 Hanifin and Rajka criteria 12
Simpson et al,35 2020 (Simpson 2020a) NCT03334396 (BREEZE-AD1) and NCT03334422 (BREEZE-AD2) Baricitinib 745/493 35.0 (12.8) 37.0 Diagnostic criteria proposed by AAD guideline 16
Simpson et al,36 2021 (Simpson 2020b) NCT03435081 (BREEZE-AD5) Baricitinib 292/146 40.0 (16.0) 50.9 Diagnostic criteria proposed by AAD guideline 16
Zhao et al,37 2021 NCT04162899 SHR0302 70/35 36.9 (14.8) 38.6 Chinese criteria 12
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Abbreviations: AAD, American Academy of Dermatology; AD, atopic dermatitis; HR, hazard ratio; ICD, International Classification of Diseases; VTE, venous thromboembolism.

Risk of Bias Assessment

The risk of bias assessment is summarized in Table 2.21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37 The 2 cohort studies were considered of high quality on the Newcastle-Ottawa Scale.21,22 As to bias in outcome measurement, 5 RCTs were rated as some concerns because there was no information about whether the outcome assessors were masked to the treatments when adjudicating VTE events.

Table 2. Summary of Risk of Bias Assessment.

Source Cohort studiesa
Representativeness of exposed group Selection of nonexposed group Ascertainment of exposure Outcome of interest not present at start of study Comparability of cohort Assessment of outcome Was follow-up long enough for outcomes to occur? Adequacy of follow-up of cohorts
Meyers et al,21 2021 1 1 1 1 1 1 1 1
Schneeweiss et al,22 2021 1 1 1 1 1 1 1 1
Source Randomized clinical trialsb
Bias arising from the randomization process Bias because of deviations from intended interventions Bias because of missing outcome data Bias in measurement of the outcome Bias in selection of the reported result
Bieber et al,23 2021 Low Low Low Low Low
Blauvelt et al,24 2021 Low Low Low Low Low
Blauvelt et al,25 2022 Low Low Low Some concerns Low
Eichenfield et al,26 2021 Low Low Low Low Low
Gooderham et al,27 2019 Low Low Low Some concerns Low
Guttman-Yassky et al,28 2020 Low Low Low Some concerns Low
Guttman-Yassky et al,29 2021 Low Low Low Low Low
Katoh et al,30 2022 Low Low Low Some concerns Low
Reich et al,31 2020 Low Low Low Low Low
Reich et al,32 2021 Low Low Low Low Low
Silverberg et al,33 2020 Low Low Low Low Low
Simpson et al,34 2020 (Simpson 2020a) Low Low Low Low Low
Simpson et al,35 2020 (Simpson 2020b) Low Low Low Low Low
Simpson et al,36 2021 Low Low Low Low Low
Zhao et al,37 2021 Low Low Low Some concerns Low
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a

Risk of bias assessed by the Newcastle-Ottawa Scale. In each domain, 1 corresponds to low risk of bias and 0 corresponds to high risk of bias. Studies with a total score (namely the sum score of all domains) of 7 or more points were considered high-quality studies.

b

Risk of bias assessed by the Cochrane Risk of Bias Tool (RoB, version 2.0).

Association of AD With Incident VTE

Two studies with 458 206 participants (397 370 and 60 836 participants in Meyers et al21 and Schneeweiss et al,22 respectively) examined the association of AD with incident VTE. The crude incidence rate of VTE among patients with AD was 0.24 and 0.18 events per 100 patient-years in Meyers et al21 and Schneeweiss et al,22 respectively. As illustrated in Figure 2, the risk for incident VTE did not significantly increase among patients with AD compared with non-AD controls (pooled HR, 0.95; 95% CI, 0.62-1.45; I2 = 92%). The overall incidence rate of VTE for patients with AD was 0.23 events per 100 patient-years.

Figure 2. Association of Atopic Dermatitis (AD) With Incident Venous Thromboembolism (VTE).

Figure 2.

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The meta-analysis found no significant association of AD with incident VTE (hazard ratio [HR], 0.95; 95% CI, 0.62-1.45). IV indicates inverse variance.

Risk of Incident VTE in Participants With AD Receiving Treatment With Janus Kinase Inhibitors

Fifteen studies with 8787 participants provided data on VTE events in patients with AD who were receiving treatment with JAK inhibitors.23,24,25,26,27,28,29,30,31,32,33,34,35,36,37 Overall, 3 of 5722 participants (0.05%) with AD receiving JAK inhibitors experienced VTE events compared with 1 of 3065 participants (0.03%) with AD receiving placebo or dupilumab. As demonstrated in eFigure 1 in the Supplement, the meta-analysis found no significant difference in the risk of incident VTE between participants with AD receiving JAK inhibitors and controls with AD receiving placebo or dupilumab (Mantel-Haenszel risk difference, 0; 95% CI, 0-0; I2 = 0%). The findings were similar across all 4 JAK inhibitors. During the placebo-controlled phase across all RCTs, the overall incidence rate of VTE was 0.15 events per 100 patient-years among participants with AD who were receiving JAK inhibitors, while the incidence rate of VTE in participants with AD receiving placebo was 0.12 events per 100 patient-years. No VTE events were recorded in the trials comparing JAK inhibitors with dupilumab. No publication bias was identified by inspecting the funnel plot (eFigure 2 in the Supplement).

Discussion

To our knowledge, this study is the first meta-analysis to investigate the risk of incident VTE in patients with AD. The evidence from cohort studies revealed no statistically significant association between AD and incident VTE. The overall incidence rate of VTE was 0.23 events per 100 patient-years among patients with AD. Meanwhile, the current evidence from RCTs demonstrated no significant differences in the risk of incident VTE between patients with AD who were receiving treatment with JAK inhibitors and patients with AD receiving placebo or dupilumab. The incidence rate of VTE was 0.15 events per 100 patient-years in patients with AD receiving JAK inhibitors.

According to a recently published guideline,42 AD has been associated with few cardiovascular comorbidities.43 The associations are not as strong as those observed with psoriasis,44,45 which do not prompt cardiovascular screening or treatment for individuals with AD. In the case of VTE, the results of the present meta-analysis suggested that AD is not a risk factor for incident VTE. By contrast, a cross-sectional survey conducted by Shaheen et al9 reported a positive association between AD and prevalent VTE (adjusted odds ratio, 1.22; 95% CI, 1.17-1.27). In a case-control study carried out by Undas et al,46 atopic diseases were more prevalent in patients with VTE (38%) than non-VTE controls (23%). Nevertheless, these studies could not assess causality and did not adjust important confounders, such as hormone therapies and smoking status.47,48 Another study using an administrative claims database from the US presented subgroup data of VTE and showed a trend of lower risks of DVT and PE in patients with AD.8

The changes in the coagulation and fibrinolysis system among patients with AD are still unclear.49,50 Elevated plasma levels of platelet activation factors have been observed in patients with AD.51 However, these coagulation markers were not associated with AD severity.52,53 Inflammatory cytokines in AD, such as interleukin (IL)–4 and IL-13, may interact with coagulation cascades in animal models.54,55 Studies have also found that proinflammatory mast cells and tryptases in AD could modulate fibrinolysis, in which is associated with a decreased risk of thrombi formation.56 More research is needed to understand whether the laboratory findings in patients with AD are clinically relevant.

Among the included RCTs, 3 VTE events occurred in participants who were receiving treatment with JAK inhibitors during the randomized placebo-controlled periods. In the JADE REGIMEN trial, a patient receiving abrocitinib, 100 mg, once daily, experienced sudden vision loss and received a diagnosis of retinal vein thrombosis.25,30 Another participant receiving abrocitinib, 200 mg, once daily, was also documented as having PE, which was not considered treatment-related by Gooderham et al.27 The other event of PE was reported with a patient receiving treatment with baricitinib, 4 mg, once daily, in the BREEZE-AD7 trial.31 However, recent studies have provided additional data on VTE in patients with AD who were receiving treatment with JAK inhibitors during the open-label extension periods. A safety analysis of abrocitinib that combined the results of 5 RCTs and a long-term extension study (JADE EXTEND) reported 5 adjudicated VTE events, all in the 200-mg group.57 In a post hoc analysis focusing on 2-mg baricitinib exclusively, no VTE events were recorded.58 During the 52-week follow-up of AD Up trials, 1 patient using upadacitinib received an incidental diagnosis of PE.59 In the present meta-analysis of JAK inhibitors, comparable risks of VTE were indicated in patients receiving JAK inhibitors and those receiving placebo or dupilumab. These results were consistent with previous meta-analyses of JAK inhibitors regarding multiple indications.11,12 Controlling inflammation via inhibition of the JAK pathways may reduce platelet activity and lower VTE events. Dose-response decreases in platelet counts have been observed in several RCTs among patients with AD treated with JAK inhibitors.25,26,60However, some of the included trials did not outline VTE risk factors of the enrollees at baseline (eg, prior VTE or recent surgical history),61 which might have introduced selection bias in reporting VTE events. With the increasing applications of JAK inhibitors in AD, more clinical data are needed to identify patients at high risk for VTE.

Strengths and Limitations

The major strength of this systematic review and meta-analysis is the inclusion of population-based cohort studies and high-quality RCTs to provide up-to-date evidence. The existing evidence from cohort studies suggests that AD is not associated with incident VTE. The evidence from RCTs indicates retention of a null hypothesis of no difference in the risk of VTE between patients with AD who were receiving treatment with JAK inhibitors and controls receiving placebo or dupilumab. Nevertheless, the results of this study need to be considered with some limitations. First, the generalizability may be limited because the included studies were mainly conducted in Western countries. Second, statistical heterogeneity was present in the meta-analysis on the association between AD and VTE. A subgroup analysis or meta-regression to identify potential effect modifiers was infeasible because of the limited number of studies (n = 2). While the crude incidence rate was similar between the 2 included cohort studies, the adjusted HRs were different. Imbalances in health care utilization and differences in confounding adjustments might explain the different risk estimates. Third, the included studies did not report the VTE risk among different patterns of AD (ie, persistent, relapsing, or adulthood-onset forms). Because age is an important risk factor for VTE,61 a subanalysis according to the onset of AD is encouraged. Fourth, the included RCTs may be underpowered or of too short duration to detect rare or long-term adverse events, such as VTE. Given the 5722 patients with AD in the JAK inhibitor group and 3065 patients in the control group, the number of participants in both arms may still be too low for inferences about safety. Hence, the results from the trial-based meta-analysis must be interpreted with caution.

Conclusions

The results of this systematic review and meta-analysis suggest that evidence from cohort studies does not detect an increased risk of incident VTE among patients with AD, nor does the evidence from RCTs detect significant differences in the risk of incident VTE between patients with AD who were receiving treatment with JAK inhibitors and controls receiving placebo or dupilumab. These findings may provide a reference for clinicians in prescribing JAK inhibitors for patients with AD. Further evidence from real-world data on longer-term safety are warranted.

Supplement.

eTable. Search Strategies for (a) MEDLINE, (b) Embase, (c) Cochrane Library, and (d) Web of Science

eFigure 1. Risk Differences in Venous Thromboembolism Between Participants With Atopic Dermatitis Receiving Janus Kinase Inhibitors and Controls Receiving Placebo or Dupilumab

eFigure 2. Funnel Plot of Randomized Controlled Trials

Click here for additional data file. (534.7KB, pdf)

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplement.

eTable. Search Strategies for (a) MEDLINE, (b) Embase, (c) Cochrane Library, and (d) Web of Science

eFigure 1. Risk Differences in Venous Thromboembolism Between Participants With Atopic Dermatitis Receiving Janus Kinase Inhibitors and Controls Receiving Placebo or Dupilumab

eFigure 2. Funnel Plot of Randomized Controlled Trials

Click here for additional data file. (534.7KB, pdf)

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