Patients who take JAK Inhibitors for Autoimmune Diseases at Lower Risk of Developing Age-Related Macular Degeneration

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New data provided evidence of a link between Janus kinase inhibitor (JAKi) therapies, a popularizing drug class in the treatment of inflammatory disease including atopic dermatitis (eczema) and a reduced risk of developing age-related macular degeneration (AMD), among patients with autoimmune diseases.

In the study across two administrative claims databases representing approximately 9.8 million patients in the US, JAKi therapy use in those aged older than 40 years with autoimmune disease was linked to a notably reduced risk of incident AMD during the first 6 to 18 months of treatment.

“Our study provides evidence of an association between JAKi therapy and a reduced risk of developing AMD in patients with autoimmune diseases,” wrote the investigative team, led by Joelle A. Hallak, PhD and Nizar Smaoui, MD, PhD, from AbbVie.

Though the etiology of the eye condition AMD is still not well understood, previous research has emphasized the role of inflammation in the development and progression of AMD—which may also implicate the positive effect of JAKi in reducing its incidence in patients with autoimmune disease.

Among key inflammation mediators, the Janus Kinase/signal transducers and activators of the transcription (JAK-STAT) signaling pathway plays an important part in immune system activation, inflammation, and hematopoiesis. Affecting the JAK-STAT pathway has been implicative across a variety of autoimmune diseases and malignancies.

Considering the potential for involvement of JAK-STAT-mediated inflammation in AMD, investigators hypothesized the use of JAKi therapy could reduce the incidence of AMD in at-risk individuals with autoimmune diseases.

The two databases were screened to identify patients who had at least one diagnosis of Crohn's disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, atopic dermatitis, psoriasis, hidradenitis suppurative, or polyarticular juvenile idiopathic arthritis, and received a first JAKi prescription or other immunotherapy. Patients were required to be continuously enrolled in the database for six or more months immediately before and after the date of the first prescription.

After initial screening and identification, individuals with autoimmune diseases who matched study eligibility criteria were matched 1:1 to eligible patients who received non-JAKi-based immunotherapy.

Most of the patient population treated with JAKi therapy was female in both the MarketScan and Optum databases, with more than 60 percent of the patient population being at least 55 years old in both cohorts.

For the MarketScan cohort, the incidence of AMD over the first six to 18 months post-index was lower in JAKi therapy-treated patients versus those on other immunotherapy. This represented a relative risk reduction of 49 percent among patients who received JAKi therapy.

In the Optum database, JAKi-treated patients had a lower AMD incidence rate than patients exposed to non-JAKis, for a relative risk reduction of 73 percent.

“Further research is required to determine the robustness and duration of this effect in larger and/or more representative patient populations and its applicability to other diseases or indications,” Hallak and colleagues added.

An original version of this article was published on sister site HCPLive.