VENOUS thromboembolism (VTE) is a common and potentially serious risk for patients with inflammatory bowel disease and rheumatoid arthritis. However, data is also needed when treating individuals with chronic inflammatory skin conditions such as a psoriasis and atopic dermatitis (AD).
Knowing the risk and rate for dermatologic conditions is vital as an early indicator of if a VTE signal is seen in patients receiving systemic immunomodulatory agents known to modulate VTE (e.g., corticosteroids and JAK inhibitors). This knowledge allows dermatologists to determine if the risk of VTE is due to the medication used or the inherent increased risk attributed to a specific inflammatory skin condition.
According to Maria Schneeweiss, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA, and colleagues, patients with chronic inflammatory skin conditions do not have an increased risk of VTE. Using Optum’s (Eden Prairie, Minnesota, USA) anonymised Clinformatics Data Mart Database, Schneeweiss and colleagues assessed the risk of VTE in patients with and without chronic inflammatory skin conditions from 2014 to 2019.
A total of 158,123 patients with inflammatory skin conditions were identified, of which 96,138 patients had psoriasis; 17,889 had alopecia areata (AA); 30,418 had AD; 7,735 had vitiligo; 5,934 had hidradenitis suppurativa; and 9 had two of this conditions. These data were compared with a control group without a chronic inflammatory skin condition (N=1,570,387).
The overall incidence rate (per 1,000 person years) for individuals with a chronic inflammatory disease was 1.53 compared with 1.76 for the healthy controls. The incidence rate for out- and inpatient VTE for AD, hidradenitis suppurativa, psoriasis, AA, and vitiligo was 1.83, 1.65, 1.57, 0.94, and 0.93, respectively.
While there is no inherent risk of VTE in patients with chronic inflammatory skin conditions, VTE remains a significant potential adverse event. As new systemic immunomodulatory agents will likely be marketed in the near future for AD, AA, and vitiligo, Schneeweiss believes that “the treatment and management will be very specific to the patient.”
