Evidence map›Paper›PMID 42575539›Full record

Observational studyRMD open2026

Whole-blood coagulation and platelet dynamics identify differential prothrombotic states in patients with rheumatoid arthritis treated with JAK or TNF-ɑ inhibitors.

Alessandro Giollo, Lorenzo Di Luozzo, Mariangela Salvato, Kiren Khalid, Riccardo D'Andrea, Andrea Benetti, Chiara Samà, Roberta Ramonda, Paolo Simioni, Luca Spiezia

Abstract readObservational Study
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In one paragraph

Observational study in RMD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Alessandro GiolloRheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy alessandro.giollo@unipd.it.ORCID http://orcid.org/0000-0001-9355-7673
Lorenzo Di LuozzoRheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Mariangela SalvatoRheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Kiren KhalidRheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Riccardo D'AndreaRheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Andrea BenettiInternal Medicine & Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Chiara SamàInternal Medicine & Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Roberta RamondaRheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.ORCID http://orcid.org/0000-0002-9683-8873
Paolo SimioniInternal Medicine & Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Luca SpieziaInternal Medicine & Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRheumatoid arthritis (RA) is associated with inflammation-driven hypercoagulability and increased venous thromboembolic risk. Post hoc analyses of safety trials have raised concerns regarding a potential differential thrombotic risk with Janus kinase inhibitors (JAKi) compared with tumour necrosis factor inhibitors (TNFi).

objectivesTo compare viscoelastic coagulation profiles and platelet reactivity in patients with RA treated with JAKi or TNFi, and in healthy controls (HC).

methodsIn this single-centre observational study, patients with RA with stable JAKi or TNFi therapy (>3 months) underwent whole-blood rotational thromboelastometry (ROTEM) and impedance aggregometry (MULTIPLATE). The primary outcomes were evaluation of: (a) whole-blood thrombogenic potential and (b) platelet reactivity. Multivariable linear regression adjusted for age, body mass index, ln-transformed Simple Disease Activity Index, treatment group and ln-transformed prednisone dose.

resultsSixty-one patients with RA (30 JAKi, 31 TNFi) and 34 HC were included. Compared with HC, patients with RA exhibited significantly higher maximum clot firmness (MCF) across all ROTEM assays (INTEM 63.4±4.0 vs 57.2±4.1 mm; EXTEM 66.2±4.1 vs 55.9±4.7 mm; FIBTEM 15.7±3.6 vs 12.4±3.7 mm; all p<0.001) and enhanced platelet aggregation (all p<0.001). In multivariable analyses, JAKi therapy (vs TNFi) was independently associated with higher EXTEM MCF (β=2.32, 95% CI 0.42 to 4.23; p=0.018) and FIBTEM MCF (β=1.72, 95% CI 0.07 to 3.37; p=0.041). Prednisone dose independently predicted INTEM and EXTEM MCF, while SDAI independently predicted ADP-induced aggregation (β=11.34, 95% CI 4.31 to 18.37; p=0.002).

conclusionsRA is characterised by enhanced clot firmness and platelet reactivity. JAKi therapy was independently associated with higher viscoelastic clot strength compared with TNFi, while inflammatory burden and glucocorticoid exposure were key determinants of prothrombotic signatures.

Indexed as

Arthritis, RheumatoidBlood CoagulationBlood PlateletsJanus Kinase InhibitorsThrombosisTumor Necrosis Factor InhibitorsAgedAntirheumatic AgentsBlood Coagulation TestsFemaleHumansMaleMiddle AgedPlatelet AggregationThrombelastographyTumor Necrosis Factor-alphaAntirheumatic AgentsJanus Kinase InhibitorsTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsArthritis, RheumatoidBiological TherapyDMARDThrombosisTumor Necrosis Factor Inhibitors

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.