Risk of venous thromboembolism in rheumatoid arthritis

Ketfi, Chahinez; Boutigny, Alexandre; Mohamedi, Nassim; Bouajil, Sara; Magnan, Benjamin; Amah, G.; Dillinger, Jean‐Guillaume

doi:10.1016/j.jbspin.2020.105122

Cited by 38 publications

(31 citation statements)

References 58 publications

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“…In fact, during these diseases, the pro-inflammatory milieu may induce a hyper-coagulation by an upregulation of procoagulant factors and a simultaneous downregulation of anticoagulant and fibrinolytic systems, thus leading to this clinical phenotype [79]. This risk is also associated with traditional CVD risk factors, such as an older age and diabetes, but also with the burden of the pro-inflammatory process over time and specific disease features [80,81]. Taking together these observations, an accurate evaluation of the hyper-coagulation burden in the patients with RMDs affected by SARS-CoV2 infection is needed, since possibly associated with a worse prognosis.…”

Section: Appraisal Of Literaturementioning

confidence: 99%

Pathogenic implications, incidence, and outcomes of COVID-19 in autoimmune inflammatory joint diseases and autoinflammatory disorders

et al. 2021

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As the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread rapidly, there are still many unresolved questions of how this virus would impact on autoimmune inflammatory joint diseases and autoinflammatory disorders. The main aim of this paper is to describe the main studies focusing their attention on COVID-19 incidence and outcomes of rheumatoid arthritis (RA), spondylarthritis (SpA), and autoinflammatory disease cohorts. We also revised possible pathogenic mechanisms associated with. Available data suggest that, in patients with RA and SpA, the immunosuppressive therapy, older age, male sex, and the presence of comorbidities (hypertension, lung disease, diabetes, CVD, and chronic renal insufficiency/end-stage renal disease) could be associated with an increased risk of infections and high rate of hospitalization. Other studies have shown that lower odds of hospitalization were associated with bDMARD or tsDMARDs monotherapy, driven largely by anti-TNF therapies. For autoinflammatory diseases, considering the possibility that COVID-19 could be associated with a cytokine storm syndrome, the question of the susceptibility and severity of SARS-CoV-2 infection in patients displaying innate immunity disorders has been raised. In this context, data are very scarce and studies available did not clarify if having an autoinflammatory disorder could be or not a risk factor to develop a more severe COVID-19. Taking together these observations, further studies are likely to be needed to fully characterize these specific patient groups and associated SARS-CoV-2 infection.

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Section: Appraisal Of Literaturementioning

confidence: 99%

Pathogenic implications, incidence, and outcomes of COVID-19 in autoimmune inflammatory joint diseases and autoinflammatory disorders

et al. 2021

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“…The present study confirmed these independent risk factors. In a study from the US, increasing age was associated with a higher risk of VTE when using any conventional DMARD or biologic for therapy 28 . The same results were found in the present study, with incidence increasing with age.…”

Section: Discussionmentioning

confidence: 99%

Effect of introducing biologics to patients with rheumatoid arthritis on the risk of venous thromboembolism: a nationwide cohort study

Chen

Kung

Chou

et al. 2021

Sci Rep

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In the United States, 100,000–300,000 patients die from venous thromboembolism (VTE) each year, with more than 500,000 people related hospitalizations. While in Europe, 500,000 people die from VTE each year. Patients with rheumatoid arthritis are at increased risk of VTE. The use of biologics in patients with rheumatoid arthritis may be associated with an increased risk of VTE. We identified all patients who had been newly approved for Catastrophic Illness Card of rheumatoid arthritis extracted the claims data from the National Health Insurance research database and Registry for Catastrophic Illness Patient Database from 2003 to 2016. VTE was defined as the presence of inpatient VTE diagnostic codes (including DVT or PE) according to the discharge diagnosis protocol. An analysis of VTE variables indicated that the incidence of VTE in the biologic group (14.33/10,000 person-years) was higher than that in the conventional drug group (12.61/10,000 person-years). As assessed by the Cox proportional hazards model, the relative HR for VTE in the biologic group (HR: 1.11; 95% CI 0.79–1.55) versus that in the conventional drug group did not reach a significant difference. In conclusion, this study found no significant differences in risk were observed between the use of conventional DMARDs and biologics.

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“…This may be due partially to the fact that most RA patients need chronic use of antiinflammatory drugs that have a mild anticoagulation effect. It may also be intrinsically linked to the process of their disease [6,7]. The explanation is unclear, but it makes their needs for anticoagulation distinct from those of osteoarthritis patients.…”

Section: Preoperative and Postoperative Considerationsmentioning

confidence: 99%

Current review of surgical management options for total knee arthroplasty in the rheumatoid knee

Iordache

Șerban

Popa

et al. 2021

Romanian Journal of Orthopaedic Surgery and Traumatology

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Rheumatoid arthritis (RA) represents a condition that can erode cartilage and damage joints, leading to inflammation and loss of movement, characterized by inflammatory synovitis. While the widespread use of potent disease-modifying medications has increased opportunities for RA patients, orthopedic surgery and complete joint arthroplasty remain an important option in end-stage joint treatment. The knee is one of the most frequently affected joints in chronic rheumatoid arthritis patients. The severity of RA ranges from a moderate illness to a serious, rapidly progressing, destructive version, gradually leading to incessant pain and joint deformity. Despite recent advances in biological agents and therapeutic modalities in the field of rheumatology, certain patients with RA, who ultimately undergo joint surgery, tend to experience progressive joint damage. Though, TKA can be performed in these patients, increased complications and poorer outcomes may result after total knee arthroplasty, because of the particularities given by RA. They are associated with extended operating time, specifically resulting in increased infection, blood loss and deep vein thrombosis. However, because RA patients present additional risk factors for complications, certain critical preoperative examination and surgical aspects need to be considered in order to maximize TKA outcomes in this subgroup of patients.

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Risk of venous thromboembolism in rheumatoid arthritis

Cited by 38 publications

References 58 publications

Pathogenic implications, incidence, and outcomes of COVID-19 in autoimmune inflammatory joint diseases and autoinflammatory disorders

Pathogenic implications, incidence, and outcomes of COVID-19 in autoimmune inflammatory joint diseases and autoinflammatory disorders

Effect of introducing biologics to patients with rheumatoid arthritis on the risk of venous thromboembolism: a nationwide cohort study

Current review of surgical management options for total knee arthroplasty in the rheumatoid knee

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