Prevalence of Cardiovascular and Cancer Risk Factors Among Rheumatoid Arthritis Patients Prescribed JAKi and TNFi: A MarketScan by Merative Cross-Sectional Study.

OBJECTIVE: To determine the prevalence of baseline risk factors for cardiovascular outcomes and cancer among commercially insured rheumatoid arthritis (RA) patients during their first dispensed treatment for either TNFi or JAKi.

METHODS: Patients with RA from 8/16/2019-3/31/2022 were identified in the Merative MarketScan® Commercial and Medicare databases. The first dispensed TNFi or JAKi was the index date and baseline risk factors were assessed among patients continuously eligible for 12-months pre-index. Patients were stratified into "elevated" risk categories: age≥65 years, smoking, and/or a history of Major Adverse Cardiovascular Event (MACE), Venous Thromboembolism (VTE), or cancer. The prevalence of modifiable risk factors was also reported: hypertension, hyperlipidemia, obesity, and diabetes. The crude prevalence and prevalence difference (PD) were reported.

RESULTS: A total of 12,673 patients [TNFi (n=7,748; 61%) and JAKi (n=4,925; 39%)] met inclusion criteria. The prevalence of "elevated" risk was the same for all TNFi (n=2,051; 26%) and JAKi (n=1,262; 26%) patients. Compared to patients at low risk, patients with an elevated risk also had a higher prevalence of at least one primary modifiable risk factor for both JAKi [79% vs. 58%; PD: 21% (95%CI: 18%-24%)] and TNFi [81% vs. 60%; PD: 21% (95%CI: 19%-23%)] patients.

CONCLUSION: In recent years, JAKi and TNFi were used in similar proportions to treat RA among commercially insured patients at elevated cardiovascular and cancer risk. Because uncontrolled disease, modifiable comorbidities, and treatment with JAKi are associated with these adverse events, future studies evaluating how practice patterns may be affected by the emergence of safety data will be of value.