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Thromb Haemost
DOI: 10.1055/a-2722-7327
Stroke, Systemic or Venous Thromboembolism

Clinical Outcomes of Venous Thromboembolism in Patients with Ankylosing Spondylitis vs. Other Immune-mediated Inflammatory Diseases: Insights from the RIETE Registry

Autoren

  • Romain Chopard 

    1   Department of Cardiology, Centre Hospitalier Universitaire de Besançon, Besançon, France
    2   SINERGIES Laboratory, University Marie and Louis Pasteur, Besançon, France
    3   F-CRIN, INNOVTE Network, Saint-Étienne, France

  • Gregory Piazza

    4   Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States

  • Laurent Bertoletti 

    3   F-CRIN, INNOVTE Network, Saint-Étienne, France
    5   Département of Médecine Vasculaire et Thérapeutique, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
    6   Mines Saint-Etienne, Université Jean Monnet Saint-Étienne, Saint-Étienne, France
    7   INSERM, SAINBIOSE U1059, Université Jean Monnet Saint-Étienne, Saint-Étienne, France
    8   INSERM, CIC 1408, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France

  • Nicolas Meneveau

    1   Department of Cardiology, Centre Hospitalier Universitaire de Besançon, Besançon, France
    2   SINERGIES Laboratory, University Marie and Louis Pasteur, Besançon, France
    3   F-CRIN, INNOVTE Network, Saint-Étienne, France

  • Leticia Guirado

    9   Department of Internal Medicine, Hospital Universitario Virgen de Arrixaca, Murcia, Spain

  • José Antonio Porras

    10   Department of Internal Medicine, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain

  • Francisco Rivera-Cívico

    11   Department of Internal Medicine, Hospital de Poniente, El Ejido, Almeria, Spain

  • José Felipe Varona Arche 

    12   Department of Internal Medicine, Hospital Universitario HM Montepríncipe, Madrid, Spain
    13   Facultad HM Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain

  • Manuel Monreal

    14   Chair for the Study of Thromboembolic Diseases, Faculty of Health Sciences, UCAM- Universidad Católica San Antonio de Murcia, Murcia, Spain
    15   CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain

  • Clément Prati

    16   Rheumatology Unit, Centre Hospitalier Universitaire de Besançon, Besançon, France
    17   UMR1098 RIGHT- EFS- INSERM, Université de Franche Comté, UFR Santé, Besançon F-25000, France
    • the RIETE Investigators
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Graphical Abstract

Abstract

Background and Objectives

Ankylosing spondylitis (AnkS) has been associated with an increased risk of venous thromboembolism (VTE). Data comparing VTE events in AnkS with other immune-mediated inflammatory diseases and non-inflammatory patients are lacking. This study aimed to compare clinical outcomes between VTE patients with AnkS, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), and patients without inflammatory disease.

Methods

We analyzed 112,539 VTE patients enrolled in the RIETE registry. A Greedy Nearest Neighbor Matching approach was used to select a comparable non-inflammatory VTE cohort. Outcomes included recurrent VTE, mortality, and major bleeding at 1 year, and were compared using Cox regression or sub-hazard models.

Results

Among the inflammatory-disease cohort of 2,427 VTE patients (mean age ± standard deviation, 64.1 ± 16 years, 41.4% males), 6.4% had AnkS, 50.6% had RA, 10.8% had SLE, and 32.2% had IBD. The matched population without inflammatory disease comprised 7,800 VTE patients. The rate of recurrent VTE was 11.5%, all-cause mortality 5.1%, and major bleeding 1.9% in AnkS patients. Similar rates were observed in patients with RA, SLE, or IBD. Recurrent VTE was significantly higher in AnkS patients than in the non-inflammatory group (HR, 7.43, 95% CI, 2.28–24.23). AnkS patients who discontinued anticoagulation earlier than 1 year experienced higher adverse outcomes (a composite of mortality, major bleeding, recurrent VTE) compared with those who pursued extended therapy.

Conclusion

VTE patients with AnkS have clinical outcomes comparable to other inflammatory diseases but a significantly increased risk of recurrent VTE compared with non-inflammatory patients, suggesting that extended anticoagulation strategies may be warranted.

Keywords

venous thromboembolism - ankylosing spondylitis - outcomes

‡ A full list of the RIETE Investigators is given in the Appendix (available in the online version only).


Supplementary Material



Publikationsverlauf

Eingereicht: 25. April 2025

Angenommen: 13. Oktober 2025

Artikel online veröffentlicht:
12. November 2025

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