Clinical Epidemiology (Jan 2022)
Glucocorticoids and Risk of Venous Thromboembolism in Asthma Patients Aged 20–59 Years in the United Kingdom’s CPRD 1995–2015
Abstract
Olulade A Ayodele,1 Howard J Cabral,2,3 David D McManus,4 Susan S Jick1,5 1Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; 2Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; 3Biostatistics and Research Design Program, Boston University Clinical and Translational Science Institute, Boston, MA, USA; 4Department of Medicine, University of Massachusetts Chan Medical School, Boston, MA, USA; 5Boston Collaborative Drug Surveillance Program, Lexington, MA, USACorrespondence: Susan S JickBoston Collaborative Drug Surveillance Program, 11 Muzzey Street, Lexington, MA, 02421, USATel +1 781 862-6660Email [email protected]: Glucocorticoids, the class of steroids used in management of asthma, have been observed to be associated with adverse events such as increased coagulation and inhibition of fibrinolysis. This study evaluated the risk of VTE in relation to the use of glucocorticoids in patients with asthma.Methods: We conducted a nested case–control study among patients aged 20– 59 years with asthma who received at least one glucocorticoid prescription during 1995– 2015 in the UK-based Clinical Practice Research Datalink GOLD. We used descriptive analyses and conditional logistic regression to evaluate the risk of VTE associated with glucocorticoid use.Results: The adjusted ORs (aORs) (95% CI) for VTE in patients exposed to glucocorticoids were 1.9 (1.6– 2.3), 1.4 (1.1– 1.8), and 1.2 (0.9– 1.5) for current, recent, and past glucocorticoid users, respectively, compared to the unexposed. The aORs (95% CI) for VTE in patients exposed to systemic glucocorticoid and inhaled glucocorticoids, compared to the unexposed, were 3.5 (2.7– 4.5) and 1.5 (1.3– 1.8), respectively.Conclusion: Current and systemic glucocorticoid use was associated with a dose-response increased risk of incident idiopathic VTE.Keywords: glucocorticoids, steroid, VTE, asthma
