VTE Risk Increased in Patients With Immune-mediated Inflammatory Diseases

Sarfaroj Khan 

Disclosures

November 04, 2020

Takeaway

  • The risk of venous thromboembolism (VTE) was increased in patients with immune-mediated inflammatory diseases (IMIDs) including ulcerative colitis (UC), Crohn’s disease (CD) and rheumatoid arthritis (RA), but there was no evidence of an association for psoriatic arthritis (PsA).

  • Risk factors in people with IMIDs included male sex, overweight/obese body mass index (BMI), smoking, fractures, use of corticosteroids and oral contraceptives and abnormal platelet count.

Why this matters

  • Knowledge of specific risk factors in people with IMIDs can help identify those susceptible to developing VTE.

Study design

  • This study included 53,378 patients with an IMID and 213,512 matched participants without IMID using UK population-based primary care data.

  • Primary outcome: diagnosis of VTE (composite of pulmonary embolism [PE] or deep vein thrombosis [DVT]).

  • Funding: Pfizer.

Key results

  • Patients with an IMID vs those without were at an increased risk of VTE (adjusted HR [aHR], 1.46; 95% CI, 1.36-1.56).

  • When assessing individual diseases, the risk was increased for CD (aHR, 1.74; 95% CI, 1.45-2.08), UC (aHR, 1.27; 95% CI, 1.10-1.45) and RA (aHR, 1.54; 95% CI, 1.40-1.70) with no significant association for PsA (aHR, 1.20; 95% CI, 0.96-1.52).

  • Associations were consistent in analyses of separate PE and DVT endpoints.

  • The risk factors for VTE in people with IMIDs included:

    • male sex (HR, 1.13; 95% CI, 1.01-1.26);

    • overweight/obese body mass index (HR, 1.23; 95% CI, 1.08-1.39 and HR, 1.66; 95% CI, 1.45-1.91);

    • current smoking (HR, 1.22; 95% CI, 1.07-1.39);

    • history of fracture (HR, 1.29; 95% CI, 1.08-1.55);

    • use of corticosteroids (HR, 1.22; 95% CI, 1.06-1.40);

    • use of combined oral contraceptives (HR, 1.63; 95% CI, 1.10-2.40); and

    • abnormal platelet count (HR, 1.23; 95% CI, 1.01-1.50).

Limitations

  • Risk of unmeasured confounding and selection bias.

 

Galloway J, Barrett K, Irving P, Khavandi K, Nijher M, Nicholson R, de Lusignan S, Buch MH. Risk of venous thromboembolism in immune-mediated inflammatory diseases: a UK matched cohort study. RMD Open. 2020;6(3). doi: 10.1136/rmdopen-2020-001392. PMID: 32994362.  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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