Risk of venous thromboembolism occurrence among adults with selected autoimmune diseases: a study among a U.S. cohort of commercial insurance enrollees

Thromb Res. 2015 Jan;135(1):50-7. doi: 10.1016/j.thromres.2014.10.012. Epub 2014 Oct 22.


Objective: This study assessed the risk of venous thromboembolism (VTE) among privately insured adults in the U.S. with one or more of the following autoimmune diseases: autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE).

Materials and methods: Using the Truven Health MarketScan® Databases, patients 18-64 years of age with a diagnosis of AIHA, ITP, RA, or SLE in 2007 and a sex and age-group matched comparison group of enrollees were followed up through 2010 to identify VTE events. Survival curve and Cox proportional hazards analyses were conducted to assess differences between groups.

Results: Among patients with AIHA, ITP, RA, or SLE, or >1 of these diseases, the risk of at least one VTE event was 19.74, 7.72, 4.90, 9.89, and 13.35 per 1,000 person-years, respectively; among the comparison group, the risk was 1.91 per 1,000 person-years. The adjusted hazard ratios (aHRs) for VTE among patients with AIHA, ITP, RA, or SLE, or >1 of these diseases (when compared with the comparison group) tended to decline over follow-up time; at 1year, the aHRs were 6.30 (95% confidence interval [CI]: 4.44-8.94), 2.95 (95% CI: 2.18-4.00), 2.13 (95% CI: 1.89-2.40), 4.68 (95% CI: 4.10-5.33), and 5.11 (95% CI: 4.26-6.14), respectively.

Conclusion: Having AIHA, ITP, RA, or SLE, or >1 of these diseases was associated with an increased likelihood of a VTE event. More research is necessary to develop better understanding of VTE occurrence among people with autoimmune diseases.

Keywords: Autoimmune diseases; Autoimmune hemolytic anemia; Immune thrombocytopenic purpura; Rheumatoid arthritis; Systemic lupus erythematosus; Venous thromboembolism.

MeSH terms

  • Adolescent
  • Adult
  • Algorithms
  • Anemia, Hemolytic, Autoimmune / complications
  • Arthritis, Rheumatoid / complications
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Insurance, Health
  • Lupus Erythematosus, Systemic / complications
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Purpura, Thrombocytopenic, Idiopathic / complications
  • Retrospective Studies
  • Treatment Outcome
  • United States
  • Venous Thromboembolism / complications*
  • Venous Thromboembolism / epidemiology
  • Young Adult