Pos0839 the comparison of malignancy risk between jak inhibitors and tnf inhibitors in multi-center cohort study

Background Ytterberg et al. demonstrated the concern about the incidence of malignancy during treatment with tofacitinib [1]. However, there is few published data of such adverse events in clinical settings. Objectives We aimed to compare the incidence of malignancies in RA patients treated with JAK inhibitors and TNF inhibitors in real-world settings. Methods We enrolled 499 RA patients treated with JAK inhibitors (tofacitinib, n=192 or baricitinib, n=104) or TNF inhibitors (adalimumab, n=88 or etanercept, n=115). The standardized incidence ratio (SIR) of malignancies were determined using the general Japanese population. After adjusting the clinical characteristic imbalance by propensity score weighting, we compared the risk of malignancy between JAK inhibitors and TNF inhibitors using Cox proportional hazard models. Results Observational period was 961.9 patient-years (PY), and median observational period was 1.3 years. We identified 11 cases (3.7%) of malignancies in JAK inhibitors and 4 cases (2.0%) in TNF inhibitors. The SIR for overall malignancies in TNF inhibitors was comparable with general population (0.94, 95%CI: 0.26–2.41), and the SIR in JAK inhibitors was higher than the general population but no significant difference (1.61/100PY, 95%CI: 0.80-2.88). The adjusted hazard ratio was 0.38 (95%CI: 0.09-1.55) between JAK inhibitors and TNF inhibitors in the risk of malignancies (Figure 1). Conclusion We demonstrated that the incidence of malignancy in JAK inhibitors was numerically high but not significant compared with general population and TNF inhibitors. Reference [1]Ytterberg SR, Bhatt DL, Mikuls TR, et al. Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis. N Engl J Med 2022; 386: 316-26. Acknowledgements: NIL. Disclosure of Interests None Declared.