Comparative safety of JAK inhibitors versus TNF inhibitors in psoriatic arthritis: a real-world propensity…

Cohort studyAnnals of medicine and surgery (2012)· Jul 2026

Comparative safety of JAK inhibitors versus TNF inhibitors in psoriatic arthritis: a real-world propensity score-matched cohort study.

Naveen Gautam, Bal Krishna Subedi, Reechashree Dhungana … Sajjan Bom Thapa

RheumatologyCohort studyClinical practice

JAK inhibitors linked to higher mortality than TNF inhibitors in psoriatic arthritis

Comparative safety of JAK inhibitors versus TNF inhibitors in psoriatic arthritis: a real-world propensity score-matched cohort study.

Naveen Gautam … Sajjan Bom Thapa

Annals of medicine and surgery (2012) · Jul 2026

Background

Janus kinase inhibitors (JAKi) and tumor necrosis factor inhibitors (TNFi) demonstrate therapeutic efficacy in psoriatic arthritis (psoriatic arthritis), yet comparative real-world safety data remain limited.

Purpose

This study quantified adverse outcome risks between JAKi and TNFi in psoriatic arthritis patients.

Methods

Retrospective cohort study utilized the TriNetX Global Collaborative Network electronic health records.

n = 2723 patients

Results

JAK inhibitor patients died at roughly double the rate of TNF inhibitor patients

HR 2.01 (95% CI 1.46 to 2.77)

CI excludes the null - significant

More results

Post-matching analysis included 2723 patients per cohort.

Rigorous adjustment eliminated a previously suspected signal for osteomyelitis.

No significant differences were observed for major adverse cardiovascular events or venous thromboembolism.

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Conclusion · 1 of 2

JAKi and TNFi exhibit distinct safety profiles in psoriatic arthritis. JAKi were associated with higher risks of mortality and severe or viral infections, whereas TNFi carried a higher skin and soft tissue infection risk.

Conclusion · 2 of 2

These findings emphasize the need for rigorous methodological adjustment in observational data and support individualized shared decision-making.

Comparative safety of JAK inhibitors versus TNF inhibitors in psoriatic arthritis: a real-world propensity score-matched cohort study.

Comparative safety of JAK inhibitors versus TNF inhibitors in psoriatic arthritis: a real-world propensity score-matched cohort study.

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