Abstract
BACKGROUND: Janus kinase (JAK) inhibitors are effective therapies for autoimmune rheumatic diseases (ARDs), but concerns persist regarding their cardiovascular effects, particularly in diverse patient populations. Identifying determinants of cardiovascular risk is essential for optimising therapy and outcomes, especially in multi-ethnic cohorts. OBJECTIVE: To assess clinical and socioeconomic determinants, including age, deprivation decile and ethnicity, in predicting cardiovascular events among patients on JAK inhibitors in a multi-ethnic cohort. METHODS: A retrospective cohort study of 309 patients with ARDs (mean age 59.3 years, 77% female, 73% White, 25% South Asian) receiving JAK inhibitors at a UK teaching hospital was conducted. Cardiovascular events, including myocardial infarctions, strokes and cardiovascular-related deaths, were recorded. Multivariate logistic regression assessed associations between age, deprivation decile, ethnicity and cardiovascular outcomes. RESULTS: The combined effect of age and deprivation decile significantly predicted cardiovascular events (p = 0.031). Older age demonstrated an odds ratio (OR) of 1.06 (95% CI: 1.00-1.13). Neither age nor deprivation decile alone achieved statistical significance, but their combination provided a robust model with an AUC of 0.837. Ethnicity was not independently predictive in this cohort. CONCLUSIONS: In a multi-ethnic cohort, age and deprivation decile jointly predict cardiovascular events in patients on JAK inhibitors. Socioeconomic factors should be integrated into cardiovascular risk assessment models to inform personalised care strategies for patients receiving JAK inhibitor therapy.