Janus Kinase inhibitors associated with reduced anterior uveitis risk in autoimmune diseases.

PURPOSE: To evaluate the impact of Janus kinase inhibitors (JAKi) compared to anti-tumor necrosis factor-α antibodies (anti-TNF) on anterior uveitis (AU) risk in patients with autoimmune diseases.

METHODS

This retrospective cohort study analyzed deidentified global electronic medical records from December 2011 to December 2023, with 2-year follow-up. Adults with ankylosing spondylitis, psoriasis, psoriatic arthritis, or inflammatory bowel disease newly prescribed JAKi or anti-TNF were included. After 1:1 propensity score matching, 3,332 matched pairs were analyzed. AU incidence was assessed using Kaplan-Meier analysis.

RESULTS

JAKi was associated with lower AU risk compared to total anti-TNF (HR: 0.43, 95% CI: 0.20–0.92) and non-monoclonal anti-TNF (HR: 0.28, 95% CI: 0.11–0.68). In ankylosing spondylitis, JAKi showed lower risk versus all anti-TNF biologics: total (HR: 0.30, 95% CI: 0.10–0.91), non-monoclonal (HR: 0.33, 95% CI: 0.11–0.99), and monoclonal anti-TNF (HR: 0.26, 95% CI: 0.09–0.78).

CONCLUSIONS

JAKi use is associated with reduced AU incidence compared to anti-TNF therapies, particularly in ankylosing spondylitis, supporting JAKi as a potential treatment option for autoimmune-related uveitis.