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Methods

PubMed, EMBASE, Cochrane Library, and clinicaltrials. gov were searched to identify randomized controlled trials evaluating the efficacy and safety of JAK inhibitors in patients with rheumatoid arthritis. The outcomes assessed were the risk of total and serious infections, tuberculosis, and herpes zoster. Sensitivity analysis disaggregated the results according to background therapy and licensed doses of JAK inhibitors.

Results

Thirty-seven randomized controlled trials that were included met the inclusion criteria. Compared with filgotinib, adalimumab (4.81; 95% confidence interval [CI], 1.39–16.66), etanercept (6.04; 95% CI, 1.79–20.37), peficitinib (7.56; 95% CI, 1.63–35.12), tofacitinib (4.29; 95% CI, 1.43–12.88), and upadacitinib (4.35; 95% CI, 1.46–13.00) have an increased risk of herpes zoster infection. Risk differences between the drugs became statistically nonsignificant when the sensitivity analysis …