VTE risk linked to high disease activity in RA
medwireNews: Rheumatoid arthritis (RA) disease activity is strongly associated with the risk for venous thromboembolism (VTE), show results from a Swedish cohort study.
Viktor Molander (Karolinska Institutet, Stockholm, Sweden) and team identified a total of 46,316 RA patients from the Swedish Rheumatology Quality Register and stratified them according to DAS28 score as being in remission or having low, moderate, or high disease activity.
Each patient was then followed up for 1 year to determine the presence of VTE events, Molander told delegates at the EULAR 2020 E-Congress.
The patients had a median age of 63 years and 74% were female. The median duration of RA was 7.8 years.
In all, there were 2158 VTE events, comprising 1388 deep vein thrombosis (DVT) events and 770 pulmonary embolism (PE) events.
Molander noted that “the incidence was slightly higher in males and increasing with higher age, which was expected.”
He also reported that there was “a clear association between disease activity and risk of VTE.”
After adjusting for sex and age, the relative risk for VTE was increased 1.99-fold among patients with high disease activity compared with those in remission and 1.45-fold for those with moderate disease activity, compared with 1.11-fold for those with low disease activity.
The absolute observed risk for a VTE event in 1 year for patients with high activity was one in 100 patients, Molander highlighted.
The team also looked at the risk ratios for VTE associated with the individual DAS28 components, and Molander reported that “supportive of the main result, the VTE risk was distributed within all of the components and not driven solely by one or two of them.” He added that there was also an association between VTE risk and increasing HAQ scores.
Patients with high disease activity were more likely to develop VTE than PE, noted Molander, at risk increases of 3.0- and 1.59-fold, respectively.
He concluded that “RA disease activity can be used as a tool for VTE risk stratification.”
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