Janus激酶抑制剂和生物制剂（JAKi /生物制剂）是治疗类风湿性关节炎（RA）的基石。我们评估了使用JAKi /生物制剂治疗血清阳性类风湿性关节炎（SPRA）患者的癌症和心血管疾病（CVDs）的风险。在2010-2020年期间，我们在国家医疗保健数据库中确定了新发SPRA的患者。研究了总体和特定部位的癌症事件，以及深静脉血栓、肺栓塞和复合心血管事件等CVD结果。通过评估发病率比率（IRRs）比较了与常规合成疾病修饰抗风湿药（csDMARD）使用者相比，使用JAKi /生物制剂的患者的癌症和CVD的相对风险。进行了时间相关的Cox分析来评估JAKi /生物制剂使用与患者结果之间的关系。共分别分析了101,816例和96,220例SPRA患者的癌症和CVD结果。与仅接受csDMARD治疗的患者相比，使用JAKi /生物制剂的患者的总癌症和CVD的IRR分别为0.88（95％置信区间[CI] 0.86-0.89）和0.91（95％ CI 0.90-0.92）。在JAKi /生物制剂使用者中，肺，肝，前列腺和皮肤癌的特定部位更常见;与其他生物制剂和csDMARD相比，JAKi未带来更大的总体CVD和癌症风险。调整后的Cox分析未对JAKi /生物制剂使用者的总癌症和CVD进行考虑。SPRA患者使用JAKi /生物制剂治疗时，总体癌症和CVD的发病率没有增加，并且相对于仅接受csDMARD治疗的患者，发病率相对较低，强调了风险缓解的最佳疾病控制。特定部位癌症的更高发病率需要进一步调查。

Janus kinase inhibitors and biologics (JAKi/biologics) are cornerstone treatments for rheumatoid arthritis (RA). We evaluated the risks of cancers and cardiovascular diseases (CVDs) in patients with seropositive RA (SPRA) treated with JAKi/biologics.Patients with new-onset SPRA during 2010-2020 in the national healthcare database were identified. Events of overall and site-specific cancers, as well as CVD outcomes, including deep vein thrombosis, pulmonary embolism, and composite cardiovascular events, were investigated. The relative risk of cancers and CVDs compared to conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) users was compared by evaluating the incidence rate ratios (IRRs). Time-dependent Cox analyses were performed to evaluate the relationship between JAKi/biologics usage and patient outcomes.A total of 101,816 and 96,220 patients with SPRA were analysed for cancers and CVD outcomes, respectively. Compared with patients treated only with csDMARDs, the IRRs of overall cancers and CVDs in patients administered JAKi/biologics were 0.88 (95% confidence interval [CI] 0.86-0.89) and 0.91 (95% CI 0.90-0.92), respectively. Site-specific lung, liver, prostate, and skin cancers were more frequent in JAKi/biologics users; JAKi did not confer a greater risk of overall CVDs and cancers compared with other biologics and csDMARDs. JAKi/biologics usage was not accounted for overall cancers and CVDs in adjusted Cox analyses.The incidence of overall cancer and CVD were not increased in patients with SPRA treated with JAKi/biologics and was relatively lower than csDMARD only users, underscoring optimal disease control for risk mitigation. The higher incidence of several site-specific cancers requires further investigation.