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Background: We performed a meta-analysis investigating the risk of developing deep vein thrombosis (DVT) and/or pulmonary embolisms (PE) in patients with inflammatory arthritis, vasculitis, and connective tissue diseases (CTD) [SLE, Sjogren's syndrome, inflammatory myositis and systemic sclerosis].
Objectives: The objectives were to determine the rate and relative increase in venous thromboembolic events in various inflammatory rheumatologic conditions compared to age and sex matched controls.
Methods: PubMed, Embase, Cochrane Databases, and Medline were searched to identify full text English publications in adults related to rheumatologic inflammatory diseases and VTE. Data regarding rates of DVTs and PEs were extracted. Using random effects models, pooled estimates for VTE in individual and pooled diseases compared with age, sex and co-morbidity matched populations where possible. Studies were excluded if VTEs were in the setting of pregnancy, post-operative outcomes or antiphospholipid antibody syndrome solely but entire SLE cohorts were included.
Results: Most of the 3,929 studies were excluded due to lack of rate or incidence of VTE. Twenty studies remained for analysis. Eight studies of RA identified 5,273,942 patients and 891,530,181 controls with a cumulative incidence of 2% (95% CI:2–3%) and OR 2.23 (95% CI:2.02–2.47) compared to age, sex, and comorbidity matched population. Six studies included 36,582 SLE patients with a cumulative incidence of 9% (95% CI:6–11%). Three Sjogren's syndrome studies with 16,180 subjects demonstrated a VTE cumulative incidence of 3% (95% CI:2–3%). Four studies of inflammatory myositis (N=8,245) yielded a VTE cumulative incidence of 4% (95% CI:2-6%). There were more VTE in SSc (3 studies), ANCA vasculitis (3), PAN (2) and AS (2). Table shows characteristics of some studies included with descriptive statistics on rates of VTEs.
First Author Year Location of Study Country Total Disease Disease with VTE Total Controls Controls with DVT SLE Sarabi ZS 2005 Toronto Canada 544 30 (N/A) (N/A) Kaiser R 2009 UCSF USA 1,930 426 (N/A) (N/A) Chang ER 2006 McGill Canada 426 40 (N/A) (N/A) Calvo-Alen J 2005 LUMINA USA 570 51 (N/A) (N/A) Romero-Diaz J 2009 Instituto Nacional Mexico 241 25 (N/A) (N/A) Gladman DD 1980 Toronto Canada 180 17 (N/A) (N/A) Zoller B 2012 MigMed2 Sweden 9,147 276 (N/A) (N/A) Ramagopalan S 2011 Oxford UK 23,544 636 (N/A) (N/A) Avina-Zubieta J 2012 UBC Canada 5,031 265 50,310 533 Sjogren's Haga HJ 2008 Haukeland Denmark 90 4 (N/A) (N/A) Zoller B 2012 MigMed2 Sweden 3,410 100 (N/A) (N/A) Ramagopalan S 2011 Oxford UK 12,680 305 (N/A) (N/A) Myositis Romero-Diaz J 2009 Instituto Nacional Mexico 24 2 (N/A) (N/A) Selva-O'Callaghan 2011 Vall Hospital Spain 97 9 (N/A) (N/A) Zoller B 2012 MigMed2 Sweden 2,122 92 (N/A) (N/A) Ramagopalan S 2011 Oxford UK 6,002 167 (N/A) (N/A)
Conclusions: Overall, these inflammatory rheumatologic diseases studied were associated with high rates of VTEs, but not all diseases were represented
Disclosure of Interest: None declared
DOI: 10.1136/annrheumdis-2014-eular.2537