Brief Communication: High Incidence of Venous Thrombotic Events among Patients with Wegener Granulomatosis: The Wegener's Clinical Occurrence of Thrombosis (WeCLOT) Study

Abstract

The incidence rate of VTEs in Wegener granulomatosis is high when compared with available rates in the general population, patients with lupus, and patients with rheumatoid arthritis. These results have important implications for clinical care of patients with Wegener granulomatosis.

Thromboembolic events as a complication of antineutrophil cytoplasmic antibody–associated vasculitis

“…Another 16 patients had a first-time VTE during the trial, and 10 (63%) of these 16 patients had active Wegener's granulomatosis at the time of the event. The incidence of VTE was 7.0 per 100 person-years, which was markedly increased over a risk of 0.3 and 0.98 per 100 person-years compared with a normal population and a cohort of SLE, respectively (5).…”

“…Merkel et al analyzed data from the Wegener's Granulomatosis Etanercept Trial, a randomized study of etanercept for the induction and maintenance of remission in Wegener's granulomatosis (5). During the recruitment phase, 13 (7.2%) patients were found to have had a prior VTE.…”

“…However, patients now face the potential of substantial treatment-related morbidity such as infections, bladder carcinoma, and myelosuppression. In addition to the typical clinical constellation and common complications, physicians are confronted with the problem of venous thromboembolism (VTE) in some cases of ANCA-associated vasculitis (4,5). During routine clinical treatment of patients with ANCA-associated vasculitis and while conducting a retrospective outcome study (3), we noticed several patients with thromboembolic events.…”

Venous thromboembolism in systemic autoimmune diseases: A narrative review with emphasis on primary systemic vasculitides

“…37 Merkel et al conducted the Wegener's clinical occurrence of thrombosis (WeCLOT) study. 38 This study was prospective observational cohort study. Patients were recruited from WEGET, a multicenter, randomized, double-blind, placebo-controlled study to evaluate the efficacy of etanercept in GPA.…”

Epidemiology of venous thromboembolism

“…Other conditions associated with VTE include autoimmune disorders [167], Behcet's syndrome, celiac disease [184], heparin-induced thrombocytopenia [185], homocystinuria and hyperhomocysteinemia [186,187], hyperthyroidism [188], immune thrombocytopenia (ITP) [189,190], infection [114], inflammatory bowel disease [191], intravascular coagulation and fibrinolysis/disseminated intravascular coagulation (ICF/DIC), myeloproliferative disorders (especially polycythemia rubra vera and essential thrombocythemia) [192,193], chronic kidney disease with severely reduced glomerular filtration rate [194], nephrotic syndrome [195], paroxysmal nocturnal hemoglobinuria [196], rheumatoid arthritis [197,198], obstructive sleep apnea [199,200], thromboangiitis obliterans (Buerger's disease), thrombotic thrombocytopenic purpura, sickle cell disease [201], systemic lupus erythematosus, and granulomatosis with polyangiitis (Wegener's) [202]. Thromboembolic complications associated with L-asparaginase therapy.…”