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New research · Internal Medicine
Journal of thrombosis and thrombolysis · 3h
Cohort studyJournal of thrombosis and thrombolysis · 2026

Risk of venous thromboembolism with upadacitinib in rheumatoid arthritis: a meta-analysis.

Lang Qin, Lin-Jing Ye, Ping Liang … Kang-Na Qin
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Internal MedicineCohort study

Upadacitinib not linked to higher venous thromboembolism risk in rheumatoid arthritis

Risk of venous thromboembolism with upadacitinib in rheumatoid arthritis: a meta-analysis.

Lang Qin … Kang-Na Qin
Journal of thrombosis and thrombolysis · 2026
Background

Upadacitinib, a selective Janus kinase (janus kinase) inhibitor, has become an effective therapeutic option for rheumatoid arthritis (rheumatoid arthritis).

Methods

We systematically searched databases, including PubMed, Embase, and the Cochrane Library, for relevant randomized controlled trials (randomized controlled trials) in rheumatoid arthritis patients that reported venous thromboembolism and its subtypes.

n = 4201 patients
Results

clotting risk was no higher with upadacitinib than comparators

RR by subgroup · 95% CI
null = 1
total VTE
0.93
nPE
0.72
nDVT
0.97
or cPE-DVT
1.32
More results

However, venous thromboembolism (venous thromboembolism) represents a potentially life-threatening complication associated with janus kinase inhibition, and uncertainties remain regarding the risk of specific venous thromboembolism subtypes with upadacitinib, including non-fatal pulmonary embolism (nPE), non-fatal deep vein thrombosis (nDVT), and concurrent pulmonary embolism and deep vein thrombosis (cPE-DVT).

More results

Heterogeneity was absent across all analyses (I 2 = 0% for all outcomes).

In this meta-analysis of randomized controlled trials, upadacitinib did not demonstrate a significantly increased risk of venous thromboembolism or its subtypes compared to controls in the studied rheumatoid arthritis population.

“
Conclusion

Despite the low overall incidence and lack of signal in this cohort, the potential venous thromboembolism risk highlighted by the FDA boxed warning necessitates careful patient selection based on comorbidities and dosage.

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