Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients

Ema Rastoder, Pradeesh Sivapalan, Josefin Viktoria Eklöf, Mohamad Isam Saeed, Alexander Svorre Jordan, Howraman Meteran, Louise Lindhardt Tønnesen, Tor Biering-Sørensen, Anders Løkke, Niels Seersholm, Thyge L. Nielsen, Jørn Carlsen, Julie Janner, Nina S. Godtfredsen, Uffe Bodtger, Christian B. Laursen, Ole Hilberg, Filip K. Knop, Helene Priemé, Truls Sylvan IngebrigtsenVibeke Gottlieb, Jon Torgny Wilcke, Jens Ulrik Stæhr Jensen

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Abstract

Due to frequent exacerbations, many patients with chronic obstructive pulmonary disease (COPD) are exposed to oral corticosteroids (OCS), which may be thrombogenic. We evaluated the risk of hospitalisation with venous thromboembolism (VTE) and death in patients with acute exacerbation of COPD (AECOPD) treated with long and short OCS regimens. In this nationwide cohort study of 30,473 COPD outpatients treated for AECOPD, we compared the risk of VTE hospitalisation and all-cause mortality within 6 months in OCS dose of >250 mg vs. ≤250 mg. A multivariable Cox proportional hazard regression was used to estimate the risk. The incidence of VTE hospitalisations was 0.23%. A long OCS treatment course was associated with an increased risk of VTE compared to a short course (hazard ratio (HR) 1.69, [95% confidence interval (CI) 1.05 to 2.72], p < 0.031). A higher risk of all-cause mortality was seen in the group of COPD patients treated with a long OCS course (HR 1.71, [95% CI 1.63 to 1.79], p < 0.0001). The risk of reported VTE hospitalisation was higher among AECOPD patients treated with long courses of OCS, but the absolute risk was low, suggesting under-reporting of the condition.

OriginalsprogEngelsk
Artikelnummer874
Antal sider10
TidsskriftBiomedicines
Vol/bind9
Udgave nummer8
DOI
StatusUdgivet - 23 jul. 2021

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