Thursday, September 26, 2013

Glucocorticoid use and increased VTE risk

Here's another one to add to the list of risk factors. From the JAMA Internal Medicine paper:

Design Population-based case-control study using nationwide databases.
Setting Denmark (population 5.6 million).
Participants We identified 38 765 VTE cases diagnosed from January 1, 2005, through December 31, 2011, and 387 650 population controls included through risk-set sampling and matched by birth year and sex...
Results Systemic glucocorticoids increased VTE risk among present (adjusted IRR, 2.31; 95% CI, 2.18-2.45), new (3.06; 2.77-3.38), continuing (2.02; 1.88-2.17), and recent (1.18; 1.10-1.26) users but not among former users (0.94; 0.90-0.99). The adjusted IRR increased from 1.00 (95% CI, 0.93-1.07) for a prednisolone-equivalent cumulative dose of 10 mg or less to 1.98 (1.78-2.20) for more than 1000 to 2000 mg, and to 1.60 (1.49-1.71) for doses higher than 2000 mg. New use of inhaled (adjusted IRR, 2.21; 95% CI, 1.72-2.86) and intestinal-acting (2.17; 1.27-3.71) glucocorticoids also increased VTE risk.

It roughly doubles the risk. Even inhaled steroids!

1 comment:

Anonymous said...

I wonder if the study might be picking up on patients with autoimmune disease. Patients with RA, SLE, Wegener's, and other inflammatory conditions are at increased risk for VTE and are likely to be on prednisone.