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.
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
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