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Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients

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 (AECOP...

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Autores principales: Rastoder, Ema, Sivapalan, Pradeesh, Eklöf, Josefin, Saeed, Mohamad Isam, Jordan, Alexander Svorre, Meteran, Howraman, Tønnesen, Louise, Biering-Sørensen, Tor, Løkke, Anders, Seersholm, Niels, Lynghøj Nielsen, Thyge, Carlsen, Jørn, Janner, Julie, Godtfredsen, Nina, Bodtger, Uffe, Laursen, Christian B., Hilberg, Ole, Knop, Filip K., Priemé, Helene, Ingebrigtsen, Truls Sylvan, Gottlieb, Vibeke, Wilcke, Jon Torgny, Stæhr Jensen, Jens Ulrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389624/
https://www.ncbi.nlm.nih.gov/pubmed/34440079
http://dx.doi.org/10.3390/biomedicines9080874
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author Rastoder, Ema
Sivapalan, Pradeesh
Eklöf, Josefin
Saeed, Mohamad Isam
Jordan, Alexander Svorre
Meteran, Howraman
Tønnesen, Louise
Biering-Sørensen, Tor
Løkke, Anders
Seersholm, Niels
Lynghøj Nielsen, Thyge
Carlsen, Jørn
Janner, Julie
Godtfredsen, Nina
Bodtger, Uffe
Laursen, Christian B.
Hilberg, Ole
Knop, Filip K.
Priemé, Helene
Ingebrigtsen, Truls Sylvan
Gottlieb, Vibeke
Wilcke, Jon Torgny
Stæhr Jensen, Jens Ulrik
author_facet Rastoder, Ema
Sivapalan, Pradeesh
Eklöf, Josefin
Saeed, Mohamad Isam
Jordan, Alexander Svorre
Meteran, Howraman
Tønnesen, Louise
Biering-Sørensen, Tor
Løkke, Anders
Seersholm, Niels
Lynghøj Nielsen, Thyge
Carlsen, Jørn
Janner, Julie
Godtfredsen, Nina
Bodtger, Uffe
Laursen, Christian B.
Hilberg, Ole
Knop, Filip K.
Priemé, Helene
Ingebrigtsen, Truls Sylvan
Gottlieb, Vibeke
Wilcke, Jon Torgny
Stæhr Jensen, Jens Ulrik
author_sort Rastoder, Ema
collection PubMed
description 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.
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spelling pubmed-83896242021-08-27 Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients Rastoder, Ema Sivapalan, Pradeesh Eklöf, Josefin Saeed, Mohamad Isam Jordan, Alexander Svorre Meteran, Howraman Tønnesen, Louise Biering-Sørensen, Tor Løkke, Anders Seersholm, Niels Lynghøj Nielsen, Thyge Carlsen, Jørn Janner, Julie Godtfredsen, Nina Bodtger, Uffe Laursen, Christian B. Hilberg, Ole Knop, Filip K. Priemé, Helene Ingebrigtsen, Truls Sylvan Gottlieb, Vibeke Wilcke, Jon Torgny Stæhr Jensen, Jens Ulrik Biomedicines Article 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. MDPI 2021-07-23 /pmc/articles/PMC8389624/ /pubmed/34440079 http://dx.doi.org/10.3390/biomedicines9080874 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rastoder, Ema
Sivapalan, Pradeesh
Eklöf, Josefin
Saeed, Mohamad Isam
Jordan, Alexander Svorre
Meteran, Howraman
Tønnesen, Louise
Biering-Sørensen, Tor
Løkke, Anders
Seersholm, Niels
Lynghøj Nielsen, Thyge
Carlsen, Jørn
Janner, Julie
Godtfredsen, Nina
Bodtger, Uffe
Laursen, Christian B.
Hilberg, Ole
Knop, Filip K.
Priemé, Helene
Ingebrigtsen, Truls Sylvan
Gottlieb, Vibeke
Wilcke, Jon Torgny
Stæhr Jensen, Jens Ulrik
Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients
title Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients
title_full Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients
title_fullStr Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients
title_full_unstemmed Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients
title_short Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients
title_sort systemic corticosteroids and the risk of venous thromboembolism in patients with severe copd: a nationwide study of 30,473 outpatients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389624/
https://www.ncbi.nlm.nih.gov/pubmed/34440079
http://dx.doi.org/10.3390/biomedicines9080874
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