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Patients with RA at increased risk for DVT, PE
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Patients with rheumatoid arthritis had a significant risk for developing deep vein thrombosis and pulmonary thromboembolism compared with patients without the conditions, according to study results.
Researchers used the Taiwan National Health Insurance Research Database to study 99% of the Taiwan population from 1998 to 2008 (n=23.74 million) and to identify 29,238 patients with rheumatoid arthritis (RA; mean age, 52.4 years; 77% women). A comparison cohort of 116,952 people without RA (controls) was matched by age, sex and index year. Cox proportional hazards regression models were used to analyze deep vein thrombosis (DVT) and pulmonary thromboembolism (PE) risk.
During a follow-up of 193,753 person-years for RA patients and 792,941 person-years for controls, there was a significantly higher overall incidence density of DVT for RA patients (10.70 vs. 3.22 per 10,000 person-years). The incidence rate ratio (IRR) was 3.34 (95% CI, 3.22-3.46) for RA patients compared with controls. Patients with RA also had a significantly higher overall incidence density of PE compared with controls (3.60 vs. 1.75 per 10,000 person-years) and an IRR of 2.06 (95% CI, 1.97-2.14). After adjustment for age, sex and comorbidities, patients with RA had an adjusted HR of 3.36 for DVT (95% CI, 2.79-4.03) and an HR of 2.07 for PE (95% CI, 1.55-2.76) when compared with controls.
“These findings highlight the importance of a multidisciplinary team adopting an integrated approach to the intervention of potential risk factors among patients with RA,” the researchers concluded. “Future research concerning RA severity scale, such as disease activity, functional impairment and physical damage are warranted.”
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Harry S. Jacob, MD, FRCPath(Hon)
Virchow would not be astonished that folk with relative (painful) mobility loss plus inflammatory provocation of clotting factor activation would be so affected.
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