Rheumatoid arthritis (with and without DMARDs) and mild psoriasis were associated with significantly elevated risks of venous thromboembolism compared to controls (HR 1.35, 1.29, and 1.07).
Cohort (n=1,483,705)
Does the presence of inflammatory disorders (psoriatic arthritis, rheumatoid arthritis, psoriasis) increase the risk of venous thromboembolism compared to population controls?
Patients with rheumatoid arthritis and mild psoriasis have a significantly elevated risk of venous thromboembolism compared to the general population, highlighting the role of systemic inflammation in VTE risk.
Effect estimate: HR 1.35, 1.29, and 1.07
Aims: To determine the risk of venous thromboembolism (VTE) defined as the combined endpoint of deep venous thrombosis (DVT) and pulmonary embolism (PE) among patients with psoriatic arthritis (PsA), psoriasis and rheumatoid arthritis (RA) compared with population controls. Methods and results: A cohort study was conducted in a primary care medical record database in the UK with data from 1994-2014 among patients with PsA, RA, or psoriasis. Cox proportional hazards models were used to calculate the relative hazards for DVT, PE, and VTE. An interaction with disease modifying anti-rheumatic drugs (DMARD) was hypothesized a priori and was significant. Patients with PsA (n = 12 084), RA (n = 51 762), psoriasis (n = 194 288) and controls (n = 1 225 571) matched on general practice and start date were identified. Patients with RA (with and without a DMARD prescription) and patients with mild psoriasis had significantly elevated risks of VTE (HR 1.35, 1.29, and 1.07, respectively) after adjusting for traditional risk factors. Severe psoriasis and PsA prescribed a DMARD had an elevated but not statistically significant risk for VTE. Findings were similar for DVT. The age-and-sex-adjusted risk of PE was elevated in RA, severe psoriasis and PsA patients prescribed a DMARD. Conclusion: While systemic inflammation is a risk factor for VTE, the risk of VTE compared with controls is different among patients with three different inflammatory disorders: RA, PsA, and psoriasis.
Ogdie et al. (Tue,) conducted a cohort in Psoriatic arthritis, psoriasis, and rheumatoid arthritis (n=1,483,705). Psoriatic arthritis, psoriasis, and rheumatoid arthritis vs. Matched general population controls was evaluated on Venous thromboembolism (combined endpoint of deep venous thrombosis and pulmonary embolism) (HR 1.35, 1.29, and 1.07). Rheumatoid arthritis (with and without DMARDs) and mild psoriasis were associated with significantly elevated risks of venous thromboembolism compared to controls (HR 1.35, 1.29, and 1.07).