TY - JOUR

T1 - Systemic corticosteroids and the risk of venous thromboembolism in patients with severe copd

T2 - A nationwide study of 30, 473 outpatients

AU - Rastoder, Ema

AU - Sivapalan, Pradeesh

AU - Eklöf, Josefin

AU - Saeed, Mohamad Isam

AU - Jordan, Alexander Svorre

AU - Meteran, Howraman

AU - Tønnesen, Louise

AU - Biering-Sørensen, Tor

AU - Løkke, Anders

AU - Seersholm, Niels

AU - Nielsen, Thyge Lynghøj

AU - Carlsen, Jørn

AU - Janner, Julie

AU - Godtfredsen, Nina

AU - Bodtger, Uffe

AU - Laursen, Christian B.

AU - Hilberg, Ole

AU - Knop, Filip Krag

AU - Priemé, Helene

AU - Ingebrigtsen, Truls Sylvan

AU - Gottlieb, Vibeke

AU - Wilcke, Jon Torgny

AU - Jensen, Jens Ulrik Stæhr

N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - COPD

KW - Corticosteroids

KW - Exacerbation

KW - Pulmonary embolism

KW - Venous thromboembolism

U2 - 10.3390/biomedicines9080874

DO - 10.3390/biomedicines9080874

M3 - Journal article

C2 - 34440079

AN - SCOPUS:85111629614

VL - 9

JO - Biomedicines

JF - Biomedicines

SN - 2227-9059

IS - 8

M1 - 874

ER -