Table 2.
Summary of Major Epidemiological Studies Evaluating Venous Thromboembolism in Rheumatoid Arthritis Patients
| First Author | Year | Country | Study Design | Sample Size | Main Outcomes |
|---|---|---|---|---|---|
| Matta et al87 | 2009 | United States | Cohort | 895,873,000 | Incident of DVT 0.9 in RA vs 0.4 in non-RA, RR 2.25. Incident of PE 1.6 in RA vs 0.9 in non-RA, RR 1.90. Incident of VTE 2.3 in RA vs 1.1 in non-RA, RR 1.99. |
| Davies et al74 | 2011 | United Kingdom | Cohort | 15,554 | IR was 3.7/1000 person-year in RA with TNFi vs 3.7/1000 person-year in RA with csDMARD. Adjusted HR of VTE with TNFi group= 0.8. |
| Kang et al88 | 2012 | Taiwan | Case control | 25,965 | OR of RA in cases of VTE= 1.92 (95% CI, 1.46–2.53; P < 0.001). |
| Holmqvist et al64 | 2012 | Sweden | Prospective cohort study | 215,175 | Prevalent cohort: IR of VTE was 5.9/1000 person-year in RA vs 2.8/1000 person-year in non-RA, HR= 2. Incident cohort: IR of VTE was 4.5/1000 person-year in RA vs 1.6/1000 person-year in non-RA, HR= 1.6. |
| Choi et al58 | 2012 | United Kingdom | Cohort | 105,365 | IR of DVT 2.1/1000 patient-year in RA vs 1.0/1000 patient-year in non-RA. IR of PE 1.5/1000 patient-year in RA vs 0.7/1000 patient-year in non-RA. IR for VTE 3.3/1000 patient-year in RA vs 1.5/1000 patient-year in non-RA. RR of VTE in RA after adjustment for multivariant 2.14. |
| Bacani et al56 | 2012 | United States | Cohort | 928 | Cumulative incidence: DVT 3.1±10 in RA vs 1.7±0.9 in non-RA (P value= 0.034)PE 4.8±1.5 in RA vs 1.6±0.7 in non-RA (P value=0.050). VTE 6.7±1.7 in RA vs 2.8±1.1 in non-RA (P value=0.005). Rate of VTE = 7.4/1000 patient-year. HR of VTE= 3.6 (95% confidence interval [95% CI] 1.5–8.6) in RA group. |
| Chung et al59 | 2013 | Taiwan | Cohort | 146,190 | IR of DVT 1.7/1000 person-years in RA vs 0.322/1000 person-years in non-RA, HR = 3.36. IR of PE 0.36/1000 person-years in RA vs 0.175/1000 in non-RA, HR= 2.07. |
| Kim et al67 | 2013 | United States | Retrospective cohort | 110,715 | IR of DVT 4.5/1000 person-year in RA vs 2.1/1000 person-year in non-RA, Risk ratio= 2.2. IR of PE 2.6/1000 person-year in RA vs 0.9/1000 person-year in non-RA, Risk ratio= 2.7. IR of VTE 6.1/1000 person-year in RA vs 2.5/1000 person-year in non-RA, Risk ratio= 2.4. |
| Yusuf et al89 | 2015 | United States | Cohort | 296,352 | IR of VTE was 4.90/1000 person-year in RA vs 1.91/1000 person-year in controls. IR of VTE was 19.74/1000 person-year in autoimmune hemolytic anemia. IR of VTE was 7.72/1000 person-year in immune thrombocytopenic purpura. IR of VTE was 9.89/1000 person-year in lupus patients. |
| Ogdie et al90 | 2018 | United States | Retrospective Cohort | 1,483,705 | IR of DVT was 3.7 and 3.4/10,000 person-year in RA with DMARDs vs no DMARDs, respectively, and 2.1/10,000 person-year in non-RA. IR of PE was 1.3 and 0.9/10,000 person-year in RA with DMARDs vs no DMARDs, respectively, and 0.5/10,000 person-year in non-RA. IR of VTE was 4.7 and 4.2/10,000 person-year in RA with DMARDs vs no DMARDs, respectively, and 2.5/10,000 person-year in non-RA. HR of VTE in RA = 1.29 in no DMARD group vs 1.35 in DMARD group. |
| Mansour et al91 | 2019 | Israel | Cohort | 69,755 | IR of VTE was 6.92% in RA vs 3.18% in non-RA. OR of VTE in RA = 2.27. |
| Galloway et al66 | 2020 | United Kingdom | Cohort | 266,890 | HR of VTE was 1.54 in RA. HR of PE was 1.57 in RA. HR of DVT was 1.64 in RA vs HR= 1 in control. HR of VTE was 1.27,1.73, 1.20 in UC, CD, PsA respectively. HR of PE was 1.23, 1.69,1.34 in UC, CD, PsA respectively. HR of DVT was 1.33,1.96,1.34 in UC, CD, PsA respectively. vs HR =1 in control. |
| Molander et al62 | 2020 | Sweden | Cohort | 262,159 | IR of DVT 0.45/1000 person-year in RA vs 0.22/1000 person-year in non-RA. IR of PE 0.26/1000 person-year in RA vs 0.14/1000 person-year in non-RA. IR of VTE 0.71/1000 person-year in RA vs 0.36 in non-RA. Adjusted RR for VTE in RA = 1.88. Within RA cohort: IR of VTE was 0.52, 0.63, 0.80,1.08 in remission, low, intermediate, and high disease activity, respectively. Adjusted RR of VTE was 1.12,1.48, and 2.03 in low, intermediate, and high disease activity, respectively. |
| Chen et al72 | 2021 | Taiwan | Cohort | 28,873 | IR of VTE in RA with csDMARD was 12.61/10,000 person-year vs 14.33 was 12.61/10,000 person-year in RA with bDMARDs. HR of VTE in bDMARDs was= 1.11 (not statically significant). |
| Dore et al92 | 2021 | United States | Retrospective cohort | VTE incident in csDMARD naive = 0.8 (0.7 for DVT, 0.3 for PE) VTE incident in csDMARD switchers= 0.7 (0.6 for DVT, 0.3 for PE) VTE incident in bDMARD switchers= 0.9 (0.7 for DVT, 0.3 for PE). | |
| Conforti et al63 | 2021 | Italy | Retrospective Cohort | IR of VTE was 7.8 per 1000 person-year in the RA cohort. IR of VTE was 1 per 1000 person-year in the general population from previous data. HR for predictive factors: Age = 1.07 (P value= 0.015) BMI = 1.37 (P value= 0.025) Disease duration= 1.13 (P value= 0.006). |
|
| Ozen et al61 | 2021 | United States | Cohort | Number of VTE events = 539 HR of BMI >30 and VTE= 1.47 HR of steroid use and VTE= 1.99 HR of age >65 and VTE= 2.32 HR of RDCI and VTE= 1.20 HR of recent fracture and VTE= 1.62 HR of hospitalization and VTE= 1.09 HR of recent surgery and VTE= 1.18. HR of moderate/sever disease activity and VTE = 1.31 |
|
| Li et al60 | 2021 | Canada | Cohort | 117,220 | IR of DVT 2.82 per 1000 person-year in RA vs.1.94/1000 person-year in non-RA. IR of PE 1.43/1000 person-year in RA vs 1.03/1000 person-year in non-RA. IR of VTE 3.79/1000 person-year in RA vs 2.70/1000 person-year in non-RA. Fully adjusted HR of VTE = 1.28. |
Abbreviations: RA, rheumatoid arthritis; VTE, venous thromboembolism; DVT, deep venous thrombosis; PE, pulmonary embolism; CI, confidence interval; OR, odds ratio; RR, relative risk; HR, hazard ratio; IR, incidence rate; DMARDs, disease-modifying anti-rheumatic drugs; csDMARDs, conventional synthetic DMARDs; bDMARDs, biological DMARDs; TNFi, tumor necrosis factor inhibitors; UC, ulcerative colitis; CD, Crohn’s disease; PsA, psoriatic arthritis; BMI, body mass index; RDCI, rheumatic disease comorbidity index.