Systemic corticosteroids and the risk of venous thromboembolism in COPD patients: A nationwide study of 30.473 outpatients with severe-very severe COPD

Background: Due to repeated exacerbations a large group of patients with chronic obstructive pulmonary disease (COPD) are often exposed to oral corticosteroids (OCS). Corticosteroids may be thrombogenic. We evaluated the risk of venous thromboembolia and death in patients with acute exacerbation of COPD (AECOPD) according to two different dosing regimens.Method: This was a nationwide observational cohort study of outpatients with COPD with a 6 month follow up time. It was based on a linked administrative registry data between January 1st 2010 and 28th February 2018. In total 30.473 patients treated with either short course (<250mg) or long course (>250mg) of OCS for AECOPD were included in the study. Cox proportional hazard regression was used to estimate the risk of VTE hospitalization or all-cause mortality.Results: The incidence of VTE was low. However, long course of OCS was associated with an increased risk of VTE compared to short course, (HR 1.73, CI 1.08 to 2.79; p < 0.0001). Furthermore, we found a higher risk of all-cause mortality in the long course group, HR 1.62 (CI 1.57 to 1.62; p<0.0001.)Conclusion: The risk of VTE hospitalization was higher among patients who used long courses of OCS, however the absolute risk was low, suggesting some under-reporting of the condition. Explanations for the finding include a true effect and residual confounding and as such our results need confirmation in experimental studies.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA2590.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).