The optimal duration of anticoagulant treatment in individuals with autoimmune diseases and venous thromboembolism (VTE) remains debatable. For a study, researchers compared the incidence rate of significant bleeding during anticoagulation to the incidence rate of VTE recurrences after treatment was stopped using the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) database.
They included 1,061 patients with autoimmune disorders and VTE who were followed up on after discontinuing anticoagulant therapy: 321 with rheumatoid arthritis, 159 with polymyalgia rheumatica, 134 with ulcerative colitis, 111 with Crohn’s disease, 82 with systemic lupus erythematosus (SLE), 58 with giant cell arteritis, 39 with ankylosing spondylitis, 64 individuals experienced severe bleeding while on anticoagulation (median, 183 days).
About 112 participants suffered symptomatic VTE recurrences after stopping anticoagulation (median, 190 days). The incidence rate of significant bleeding during therapy was similar in most subgroups to the incidence rate of VTE recurrences after medication termination. However, in patients with SLE (10.0 major bleeds, 95% CI 4.07–20.9) or ankylosing spondylitis (10.9 major bleeds [95% CI 3.47–26.3] vs. 4.69 VTE recurrences, 95% CI 1.19–12.8), the incidence rates of major bleeding during anticoagulation were more than twofold higher than the incidence rates of VTE recurrences after its discontinuation.
Reference:onlinelibrary.wiley.com/doi/10.1111/bjh.18124
