What This Means
This study looked at a large US database of spontaneously reported side effects (FAERS) to compare heart and blood-vessel problems reported with two anti-inflammatory drugs, tocilizumab and baricitinib. Both drugs are used for rheumatoid arthritis, and both were also used to treat COVID-19. The researchers examined nearly 6,000 cardiovascular reports, including arrhythmias, strokes, blood clots, ischemic heart disease, and heart inflammation.
For both drugs, cardiovascular reports were disproportionately higher after COVID-19 emergency authorization than before. The signal was strongest for baricitinib used for COVID-19, where cardiovascular events were reported far more often relative to other reports in the database than for other drug-use combinations. Machine learning models picked up COVID-19 as an important factor for baricitinib and rheumatoid arthritis for tocilizumab, though the models' predictive ability was only moderate.
This research suggests that the cardiovascular safety picture of these drugs may depend on the condition being treated. However, the data come from voluntary reports, which cannot prove that a drug caused a problem or give true rates of risk. The findings point to the need for careful, context-specific safety evaluation when existing drugs are repurposed for new illnesses.