Abstract Number: OC 06.2
Meeting: ISTH 2022 Congress
Background: The recurrence risk of systemic lupus erythematosus (SLE)-associated venous thromboemblism (VTE) is currently not well known.
Aims: To determine the recurrence risk of SLE-associated VTE and to explore the influence of provoking factors and SLE-flare at time of index-VTE
Methods: A multi-centre, retrospective follow-up of a cohort of patients with a first SLE-associated VTE and who discontinued anticoagulation therapy. As formal SLE-diagnosis might not have been established at index-VTE, all VTE occurring since one year before diagnosis of SLE was considered SLE-associated. SLE-flares were defined as SLEDAI-index >4. The primary outcome was recurrent VTE, defined as any deep vein thrombosis.
Incidence rates and cumulative incidences were calculated stratified by presence of a provoking factor and anti-phospholipid syndrome/antibodies (APS) at index-VTE. The hazard ratio (HR) for recurrence risk after SLE-flare associated index-VTE was estimated in a Cox-regression, adjusted for provoking factor and APS.
Results: Eighty patients were included. Follow-up was 8(3-16) years (median, interquartile range); mean(±SD) age was 39±16 years, 66(83%) were female. Twenty-one recurrent VTE occurred.
In stratum ‘provoked index-VTE’, recurrence rate in patients without APS was 1.1/100 person-years (95% confidence interval [CI] 0.1-3.1) and in presence of APS 3.5/100 person-years (95% CI 0.9-8.9), yielding cumulative incidences of 7.5% (95% CI 1.2-21.7%) and 31.4% (95% CI 6.3-61.6%) respectively.
In stratum ‘unprovoked index-VTE’, recurrence rate in patients without APS was 3.8/100 person-years (95% CI 1.2-9.0) and in presence of APS 16.7/100 person-years (95% CI 4.5-42.7), yielding cumulative incidences of 33.7% (95% CI 10.7-58.9%) and 54.2% (95% CI 10.7-84.5%) respectively.
Fourty-six index-VTE were flare-associated and the adjusted HR for recurrent VTE was 0.4 (95% CI 0.1-1.0).
Conclusion(s): APS is the main determinant for recurrence risk of SLE-associated VTE irrespective of the presence of a provoking factor. SLE-flare at index-VTE might be associated with a lower recurrence risk.
To cite this abstract in AMA style:
Bhoelan S, Borjas Howard J, Tichelaar V, van Daele P, Hak L, Voskuyl A, Limper M, goekoop R, Teng O, Vosters J, Bijl M, Zirkzee E, Schilder A, Bernelot Moens H, de Leeuw K, Meijer K. Recurrence risk of a first systemic lupus erythematosus-associated venous thromboembolism: a retrospective cohort study [abstract]. https://abstracts.isth.org/abstract/recurrence-risk-of-a-first-systemic-lupus-erythematosus-associated-venous-thromboembolism-a-retrospective-cohort-study/. Accessed March 21, 2024.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/recurrence-risk-of-a-first-systemic-lupus-erythematosus-associated-venous-thromboembolism-a-retrospective-cohort-study/