Key points What is the rate of history of venous thromboembolism (VTE) in patients with bullous pemphigoid in the US? Findings In this cohort study that included 2,654 bullous pemphigoid patients and 26,814 comparison patients or controls, a large-scale analysis of US claims data found a 2-fold increased risk of VTE clinical events in patients with bullous pemphigoid compared to similar patients without the disease. Which means doctors should be aware of an increased risk of VTE when treating patients with bullous pemphigoid. Importance Studies have linked bullous pemphigoid (BP) to venous thromboembolism (VTE) in several data sources and have found 6- to 15-fold increased incidence rates. |
Aim
To determine the incidence of VTE in patients with AP compared to similar controls.
Design, scope and participants
This cohort study used insurance claims data from a US national healthcare database Ninth Revision (ICD-9) 694.5 and ICD-10 L12.0] recorded by dermatologists within 1 year).
Risk-based sampling identified comparison patients without bullous pemphigoid (BP) and free of other chronic inflammatory skin diseases.
Patients were followed until the first of the following events occurred: VTE, death, disenrollment, or end of data flow.
Exhibitions
Patients with BP compared to those without bullous pemphigoid (BP) and free of other chronic inflammatory skin diseases (CISD).
Main result
Venous thromboembolism events were identified and incidence rates were calculated before and after propensity score (PS) matching to account for VTE risk factors.
Hazard ratios (HRs) compared the incidence of VTE in BP versus non-CISD.
Results
Overall, 2,654 patients with bullous pemphigoid (BP) and 26,814 comparison patients without BP or other chronic inflammatory skin diseases (CISD) were identified.
The mean (SD) age in the BP group was 73.0 (12.6) years and 55.0 (18.9) years in the non-CSID group.
With a median follow-up time of 2 years, the unadjusted incidence rate (per 1000 person-years) of VTE in outpatients or inpatients was 8.5 in the BP group compared with 1.8 in patients without CISD.
Adjusted rates were 6.7 in the BP group compared with 3.0 in the non-CISD group. The age-adjusted incidence rates (per 1000 person-years) in patients aged 50 to 74 years was 6.0 (vs. 2.9 in the non-CISD group) and in those aged 75 years and older it was 7.0. 1 (versus 4.53 in the group without CISD).
After 1:1 propensity score matching including 60 VTE risk factors and severity markers, BP was associated with a 2-fold increased risk of VTE (2.24 [1.26-3.98]). compared to those in the group without CISD. When restricted to patients aged 50 years or older, the adjusted relative risk of VTE was 1.82 (1.05-3.16) for the BP versus non-CISD groups.
Conclusions In this US national cohort study, bullous pemphigoid (BP) was associated with a two-fold increased incidence of venous thromboembolism (VTE) after controlling for venous thromboembolism (VTE) risk factors in a patient population dermatological. |
