Background: Patients with autoimmune rheumatic diseases such as Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis receiving Janus kinase (JAK) inhibitor therapy may face an increased risk of cardiovascular events if the patient has multiple co-morbidities. Identifying individuals at higher risk can inform targeted preventive interventions. This study aimed to assess the predictive value of the age of the patient and deprivation deciles in identifying patients susceptible to cardiovascular events while undergoing JAK inhibitor therapy. Objectives: To assess the predictive value of age and deprivation deciles in identifying patients at risk of cardiovascular events while on JAK inhibitor therapy for autoimmune rheumatic diseases. Methods: A retrospective cohort study was conducted across three hospitals sites, enrolling patients diagnosed with Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis registered on the biologics data base of a busy University Teaching Hospital in the United Kingdom treated with JAK inhibitors. Baseline patient characteristics, such as age, gender ethnicity, comorbidities, smoking status, and lipid profile were collected. Patients who have had a cardiovascular event while on JAK inhibitor therapy were identified retrospectively. Results: - A total of 309 patients, with a mean age of 59.3 (SD±12.3) years, were included in the study. The majority of patients enrolled in the biologics database taking JAK inhibitor therapy were female (77%). Cardiovascular events, including myocardial infarctions, strokes, and cardiovascular-related deaths which had occurred while on therapy were recorded. The mean Q-risk score was 12% (SD±10.45), indicating a moderate level of cardiovascular risk. Furthermore, the most common deprivation decile in the cohort is 3 with 1 being the most deprived areas and 10 reflecting the least deprived areas in terms of socio-economic circumstances. A multivariate logistic regression analysis, adjusting for potential confounders, such as type of JAK inhibitor therapy, ethnicity, gender disease sub-type showed that the Age of the patient along with deprivation decile created a model which was statistically significant (P value = 0.031) in predicting a binary outcome which favours having a cardiovascular event. Neither Age of the patient nor deprivation deciles alone were statistically significant in predicting a cardiovascular event while on JAK inhibitor therapy. Patients pf older age had an odds ratio of 1.06 (95% CI: 1.00-1.13), for an increased risk of cardiovascular events. The logistic regression model as a whole was statistically significant (Chi2(14) = 24.04, p 0.031, n = 309). The AUC of the ROC curve was 0.837. Conclusion: This study demonstrates that the age of the patient and deprivation decile can effectively predict cardiovascular events in patients using JAK inhibitor therapy for autoimmune rheumatic disease. Older patient age alongside deprivation decile were predictors of increased cardiovascular event risk but either indices was not significant alone even after adjusting for potential confounders for cardiovascular risk. Incorporating these predictive tools into routine clinical practice can aid in identifying patients who warrant intensified cardiovascular risk management when initiating JAK inhibitor therapy. Further research is warranted to validate and refine these predictive models and assess their impact on patient outcomes. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
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