title: Risk of venous thromboembolism occurrence among adults with selected autoimmune diseases: a study among a U.S. cohort of commercial insurance enrollees.
abstract: OBJECTIVE
  This study assessed the risk of venous thromboembolism (VTE) among privately insured adults in the U.S. with one or more of the following autoimmune diseases: autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE).
  
  
  METHODS
  Using the Truven Health MarketScan® Databases, patients 18-64 years of age with a diagnosis of AIHA, ITP, RA, or SLE in 2007 and a sex and age-group matched comparison group of enrollees were followed up through 2010 to identify VTE events. Survival curve and Cox proportional hazards analyses were conducted to assess differences between groups.
  
  
  RESULTS
  Among patients with AIHA, ITP, RA, or SLE, or >1 of these diseases, the risk of at least one VTE event was 19.74, 7.72, 4.90, 9.89, and 13.35 per 1,000 person-years, respectively; among the comparison group, the risk was 1.91 per 1,000 person-years. The adjusted hazard ratios (aHRs) for VTE among patients with AIHA, ITP, RA, or SLE, or >1 of these diseases (when compared with the comparison group) tended to decline over follow-up time; at 1year, the aHRs were 6.30 (95% confidence interval [CI]: 4.44-8.94), 2.95 (95% CI: 2.18-4.00), 2.13 (95% CI: 1.89-2.40), 4.68 (95% CI: 4.10-5.33), and 5.11 (95% CI: 4.26-6.14), respectively.
  
  
  CONCLUSIONS
  Having AIHA, ITP, RA, or SLE, or >1 of these diseases was associated with an increased likelihood of a VTE event. More research is necessary to develop better understanding of VTE occurrence among people with autoimmune diseases.
authors.affiliation: Office of Science and Public Health Practice, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-K72, Atlanta, GA 30333. Electronic address: hyusuf@cdc.gov.
authors.forename: Hussain R
authors.initials: HR
authors.lastname: Yusuf
authors.affiliation: Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-E64, Atlanta, GA 30333.
authors.forename: W Craig
authors.initials: WC
authors.lastname: Hooper
authors.affiliation: Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-E64, Atlanta, GA 30333.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
authors.affiliation: Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-E64, Atlanta, GA 30333.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Parker
authors.affiliation: Division Of Reproductive Health, National Center on Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-F74, Atlanta, GA 30333.
authors.forename: Sheree L
authors.initials: SL
authors.lastname: Boulet
authors.affiliation: Hemostasis and Thrombosis Center, Duke University Medical Center, 40 Duke Medicine Circle, Durham, NC 27710.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Ortel
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications; D001172:Arthritis, Rheumatoid / Q000150:complications; D001327:Autoimmune Diseases / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007348:Insurance, Health; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D054556:Venous Thromboembolism / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
keywords: Autoimmune diseases; Autoimmune hemolytic anemia; Immune thrombocytopenic purpura; Rheumatoid arthritis; Systemic lupus erythematosus; Venous thromboembolism