Incidence and risk factors of venous thromboembolism in ANCA-associated vasculitis: a metaanalysis and metaregression
- 1 July 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Clinical Rheumatology
- Vol. 40 (7), 2843-2853
- https://doi.org/10.1007/s10067-021-05589-8
Abstract
The incidence of venous thromboembolism (VTE) in ANCA-associated vasculitis patients varies in different populations. Moreover, the risk factors for VTE in these patients are poorly described due to the small number of events. Ovid MEDLINE, EMBASE, and the Cochrane Library were searched for eligible articles. The inclusion criteria included observational studies that enrolled patients age >= 18 years diagnosed with ANCA-associated vasculitis. The incidence of VTE is the outcome of interest. Of 1362 citations, a total of 21 studies (n = 4422) dated from 2006 to 2019 were included in the systematic review. The mean age was 54.2 +/- 4.0 years. Most were male (52.0%) and Caucasian (80.9%). With a mean follow-up duration of 5.2 +/- 2.8 years, the pooled incidence of VTE in ANCA-associated vasculitis patients was 12.4% (95% CI, 8.8-17.2). Of these, 63.4% (95% CI, 57.3-69.1) had deep vein thrombosis and 26.3% (95% CI, 17.6-37.4) had pulmonary embolism. Recurrent VTE occurred in 10.0% (95% CI, 5.2-18.6). From the metaregression adjusted for age, sex, and ethnicity; positive MPO-ANCA, increasing Birmingham Vasculitis Activity Score at time of vasculitis diagnosis, and presence of renal involvement were positively associated with increased VTE events. Positive PR3-ANCA profile was inversely associated with increased VTE events. Increasing follow-up duration was not associated with increased VTE events. VTE in ANCA-associated vasculitis is common. Positive MPO-ANCA, increasing vasculitis activity, and presence of renal involvement were significant risk factors for VTE while positive PR3-ANCA was inversely associated with increased VTE.This publication has 54 references indexed in Scilit:
- Clinical Outcomes of Remission Induction Therapy for Severe Antineutrophil Cytoplasmic Antibody–Associated VasculitisArthritis & Rheumatism, 2013
- Venous Thromboembolism in Patients with Membranous NephropathyClinical Journal of the American Society of Nephrology, 2012
- A model to predict cardiovascular events in patients with newly diagnosed Wegener's granulomatosis and microscopic polyangiitisArthritis Care & Research, 2011
- Increased incidence of cardiovascular events in patients with antineutrophil cytoplasmic antibody–associated vasculitides: A matched‐pair cohort studyArthritis & Rheumatism, 2009
- High frequency of venous thromboembolic events in Churg–Strauss syndrome, Wegener’s granulomatosis and microscopic polyangiitis but not polyarteritis nodosa: a systematic retrospective study on 1130 patientsAnnals Of The Rheumatic Diseases, 2008
- Thromboembolic events as a complication of antineutrophil cytoplasmic antibody–associated vasculitisArthritis Care & Research, 2006
- Measuring inconsistency in meta-analysesBMJ, 2003
- Internalization of Proteinase 3 Is Concomitant with Endothelial Cell Apoptosis and Internalization of Myeloperoxidase with Generation of Intracellular OxidantsThe American Journal of Pathology, 2001
- Publication bias in clinical researchThe Lancet, 1991