The risk of venous thromboembolism in immune-mediated inflammatory diseases: a UK matched cohort study

James Galloway, Kevin Barrett, Peter Irving, Kaivan Khavandi, Monica Nijher, Ruth Nicholson, Simon de Lusignan, Maya Buch

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives
To describe the risk of venous thromboembolism (VTE), and risk factors for VTE, in people with immune-mediated inflammatory diseases (IMID) [ulcerative colitis, Crohn’s disease, rheumatoid arthritis, and psoriatic arthritis], compared to a matched control population.
Methods
53378 people with an IMID were identified over 1999-2019 in the UK Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database and were matched to 213512 people without an IMID. The association between the presence of any IMID, and each IMID separately, and risk of VTE was estimated using unadjusted and multivariable adjusted Cox proportional hazards models. The prevalence of VTE risk factors, and associations between VTE risk factors and risk of VTE, were estimated in people with and without an IMID.
Results
People with an IMID were at increased risk of VTE (adjusted Hazard Ratio [aHR] 1.46, 95% confidence interval [CI] 1.36,1.56), compared to matched controls. When assessing individual diseases, risk was increased for Crohn’s disease (aHR 1.74, 95%CI 1.45,2.08), ulcerative colitis (aHR 1.27, 95% CI 1.10,1.45) and rheumatoid arthritis (aHR 1.54, 95% CI 1.40,1.70) but there was no evidence of an association for psoriatic arthritis (aHR 1.21, 95% CI 0.96,1.52). In people with an IMID, independent risk factors for VTE included male sex, overweight/obese BMI, current smoking, history of fracture, and, across study follow-up, abnormal platelet count.
Conclusions
VTE risk is increased in people with IMIDs. Routinely available clinical information may be helpful to identify individuals with an IMID at increased future risk of VTE.
Original languageEnglish
JournalRMD Open
Publication statusAccepted/In press - 5 Sept 2020

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