Risk of nonmelanoma skin cancer in patients taking Janus kinase inhibitors for inflammatory bowel disease: A systematic review and meta-analysis

Abstract

Background: Janus kinase (JAK) inhibitors are promising for inflammatory bowel diseases (IBDs), but their long-term safety, including risks of nonmelanoma skin cancer (NMSC), is uncertain. Objectives: The objective of the study was to conduct a systematic review and meta-analysis to examine the risk of NMSC in patients taking JAK inhibitors for IBDs during the induction trial, maintenance trial, and long-term extension (LTE) of treatment. Methods: We searched the PubMed, Embase, and Cochrane databases to identify studies reporting NMSC with the use of JAK inhibitors. Results: In total, we retained 22 references that included 31 trials for a qualitative systematic review and 28 trials for a quantitative meta-analysis. Average risk differences were < 0.0001 (P = 0.980) in induction trials, 0.002 (P = 0.546) in maintenance trials, and 0.019 (P = 0.012) in LTE trials. Subgroup analyses showed that there were no significant differences between generic drugs, trial phases, ages, or genders. Conclusion: In patients with an IBD, there was no statistically significant difference in the risk probability of NMSC occurrence whether or not JAK inhibitors were used, regardless of the follow-up period during induction and maintenance studies. Furthermore, the overall estimated NMSC incidence rate was significantly higher than the reference incidence. Although large heterogeneity among trials, both gastroenterologists and dermatologists still should be cautious of appropriate skin screening for IBD patients using JAK inhibitors.

Keywords

• adverse event
• inflammatory bowel disease
• janus kinase inhibitor
• nonmelanoma skin cancer
• safety