Increased Risk for Venous Thromboembolism Events in Patients With PsA Linked to Underlying Comorbidities

Among patients with psoriatic arthritis (PsA), the increased risk for venous thromboembolic (VTE) events is associated with underlying comorbidities, according to study results published in Arthritis Research & Therapy.

The researchers sought to evaluate the link between PsA and VTE events, using a large population-based database.

A retrospective cohort study was conducted using the computerized database of Clalit Health Services (CHS), the largest healthcare provider in Israel. Researchers used the CHS database to collect data of adult patients newly diagnosed with PsA between January 1, 2003 (ie, the start date), and December 31, 2018, with the date of diagnosis considered the index date. Risk set sampling was used to randomly select 4 or more control participants without PsA as a comparator group for each patient with PsA who was included in the study. The control participants were matched by age (within 1 year), sex, ethnic group (Jewish or Arab), and index date. Participants in both of the groups were followed up with from the index date until the initial occurrence of a hospital-based diagnosis of a VTE event, death, or the end of follow-up on June 30, 2019 (ie, the end date), whichever occurred first.

The study outcome was a primary discharge diagnosis of VTE, including the composite of deep vein thrombosis and pulmonary embolism.

A total of 5275 patients were enrolled in the PsA cohort. Overall, 53.2% were women. The mean participant age was 51.7±15.4 years. The control group included 21,011 individuals who were matched with the PsA cohort for age, sex, ethnicity, and index date.

Overall, 1.2% (n=62) of patients in the PsA group were diagnosed with VTE, compared with 0.8% (n=176) of individuals in the control group (hazard ratio [HR], 1.40; 95% CI, 1.05-1.87; P =.023).

Based on the multivariable analysis, the researchers did not observe a significantly increased risk for VTE among patients with PsA compared with control participants (HR, 1.27; 95% CI, 0.91-1.80; P =.16).

In the PsA group, individuals were more often older and had a history of VTE (HRs, 1.08 and 31.63, respectively; P <.0001 for both), demonstrating that age and prior VTE were the only risk factors associated with an increased risk for VTE among patients with PsA.

Patients in the PsA vs control group more often had psoriasis (80.5% vs 1.6%; P <.0001) and a greater prevalence of cardiovascular disease-associated risk factors, such as diabetes (33.8% vs 26.2%; P <.0001) and obesity (body mass index ≥30 in 33.5% vs 25.8%; P <.0001).

Study limitations included the relatively small of VTE events among patients with PsA in the CHS database; the lack of clinical data on disease activity in PsA; and the fact that psoriasis alone was not analyzed.

The researchers concluded, “Given the association of VTE with comorbidities common in [patients with] PsA, our findings do support continued research into VTE risk factors in PsA and active surveillance of this patient population for VTE occurrence especially in an era of medications such as [Janus kinase] inhibitors.”

Reference

Gazitt T, Pesachov J, Lavi I, et al. The association between psoriatic arthritis and venous thromboembolism: a population-based cohort study. Arthritis Res Ther. 2022;24(1):16. doi:10.1186/s13075-021-02703-8