NMSC risk in RA patients initiating JAK inhibitors vs. IL-6 receptor inhibitors, using UK registry data (BSRBR-RA linked to NCRAS) with IPTW-adjusted Cox models; first 90 days excluded, median follow-up ~3.3 years.
Among 3,985 patients with 116 NMSC events, JAKi was associated with a higher but non-statistically significant NMSC risk vs. IL-6Ri (IPTW HR 1.64, 95% CI 0.85–3.17); absolute rate difference of 3.3 events/1,000 person-years, equating to ~1 extra NMSC per 307 patients treated with JAKi for one year.
Confidence intervals cross 1.0, so the elevation in risk is not statistically significant and may reflect chance. The study is observational, and residual confounding cannot be excluded despite IPTW. The relatively small number of NMSC events (n=116) limits precision.
JAKi appears to carry a modestly higher NMSC risk than IL-6Ri in RA, though the difference is small and uncertain — roughly 1 extra case per 307 patients per year. Rheumatologists should factor NMSC risk into shared decision-making, especially for patients with prior skin cancer history or other risk factors.
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