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.
- 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.
- 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).
- Risk of unmeasured confounding and selection bias.
References
References
