VTE risk elevated in people with psoriasis

1 February 2012

MedWire News: People with psoriasis may have an increased risk for venous thromboembolism (VTE), results from a large study among US women suggest.

“Recently there has been considerable interest in whether systemic inflammation is a risk factor for VTE, as inflammation is associated with a procoagulant state,” explain Pamela Lutsey (University of Minnesota, Minneapolis) and colleagues in the Journal of Thrombosis and Haemostasis.

This interest extends to investigations into associations between VTE risk and medical conditions characterized by chronic systemic inflammation, such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease.

In the present study, Lutsey and team used data from the Iowa Women’s Health Study to investigate whether psoriasis in particular is associated with an elevated risk for incident VTE.

The analysis included data from 38,608 women, aged a mean of 68.1 years at baseline, who were followed-up for a median of 11.3 years.

During the follow-up period, 859 (2.2%) women developed psoriasis. Women who developed psoriasis were more likely to be young, highly educated, be smokers, have higher body mass index (BMI), be diabetic, and be using hormone therapy than women who did not develop the condition.

There were 1825 VTE events recorded during the course of the study, 37 of which were preceded by a diagnosis of psoriasis.

Age-adjusted multivariate analysis showed that women who developed psoriasis had a 40% increased risk for VTE compared with those who did not. Additional adjustment for education, smoking status, BMI, diabetes, and hormone use attenuated the risk by just 1%.

The researchers say that their findings are in line with those of other recent studies, which have suggested that psoriasis is associated with an increased risk for VTE.
However, the current results extend previous work because they controlled for lifestyle and anthropometrics, and included outpatient psoriasis cases, they add.

Lutsey et al say that while their findings contribute to ongoing discussions about whether chronic systemic inflammation causes VTE, they are probably of little clinical impact.

“Given the modest hazard ratio and relatively low incidence of VTE, a diagnosis of psoriasis would not justify special VTE prevention,” they write.

Furthermore, since individuals with moderate and severe psoriasis have an increased risk for atherosclerotic cardiovascular disease, they may already be targeted for cardiopreventive therapies, such as weight loss and statins, which may also lower VTE risk, the team concludes.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

J Thromb Haemost 2012; Advance online publication