Recent advances in immunology enabled the characterization of several signal transmitting pathways responsible for proper cytokine and chemokine signaling. Among them, Janus kinases (JAKs) are essential components of receptor activation systems. The discovery of JAK kinases enabled the synthesis of JAK kinase inhibitors (JAKi or Jakinibs), which have proven to be efficacious in the treatment of hematologic malignancies and several rheumatological disorders and continue to be investigated in many clinical indications. Blocking multiple cytokines belonging to several cytokine families with a single small molecule may, however, create a potential risk for the patients. Recently, a higher risk of thromboembolic complications, namely, deep vein thrombosis and pulmonary embolism, has been recognized as the main concern during treatment with Jakinibs. At present, it is not entirely clear whether this increased risk is related to direct cytokine blockade, the presence of concomitant diseases in treated patients or other unknown circumstances that work together to increase the risk of this side effect. In this review, we discuss data on the risk of thromboembolic side effects, with special emphasis on the mechanism that may be responsible for this increased risk. Many indirect data indicate that higher thromboembolic risk may be related to the specificity of JAK inhibitor action, such that preferentially blocking one signaling pathway upsets the balance between pro and anti-thrombotic activities.

Janus kinase (JAK) inhibitors, a novel class of targeted synthetic disease-modifying antirheumatic drugs (DMARDs), have shown their safety and efficacy in rheumatoid arthritis (RA) and are being intensively tested in other autoimmune and inflammatory disorders. Targeting several cytokines with a single small compound leads to blocking the physiological response of hundreds of genes, thereby providing the background to stabilize the immune response. Unfortunately, blocking many cytokines with a single drug may also bring some negative consequences. In this review, we focused on the activity of JAK inhibitors in the cardiovascular system of patients with RA. Special emphasis was put on the modification of heart performance, progression of atherosclerosis, lipid profile disturbance, and risk of thromboembolic complications. We also discussed potential pathophysiological mechanisms that may be responsible for such JAK inhibitor-associated side effects.

Background: Art-based interventions, including music therapy, are increasingly used in palliative care to support symptom management and improve quality of life in patients with advanced cancer. This systematic review and meta-analysis aimed to evaluate their efficacy in adults with advanced cancer receiving palliative care. Methods: The review protocol was registered in PROSPERO (CRD42025636049). A systematic search of PubMed, MEDLINE (Ovid), and Embase was conducted from database inception to 17 December 2024 (PubMed), 21 December 2024 (MEDLINE (Ovid)), and 10 January 2025 (Embase), and was updated in February 2026. Additional searches were conducted in ClinicalTrials.gov, WHO ICTRP, Cochrane CENTRAL, and Google Scholar in August 2026. Studies comparing art-based interventions with standard care or active control interventions were included. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence using the GRADE approach. Results: Eleven reports with 9 RCTs (involving 675 patients) met the inclusion criteria, all evaluating music-based interventions. Music-based interventions in addition to routine palliative care were associated with a statistically significant reduction in pain intensity compared with control conditions (SMD = −0.51; 95%CI: −0.98 to −0.03; p = 0.04; k = 3; n =224), although high between-study heterogeneity was observed (I² = 67.69%). They were also associated with higher quality-of-life scores (SMD = 0.92; 95%CI: 0.59 to 1.24; p < 0.0001; k = 2; n = 168; I² = 0%); however, the certainty of evidence was very low, making this effect highly uncertain. Conclusions: Evidence for music-based interventions remains very uncertain, precluding firm conclusions regarding clinical benefit. Further high-quality trials, including other forms of art-based interventions, are needed.