Romatoid artrit hastalarında venöz tromboembolizm riskinde hidroksiklorokinin ve komorbiditenin rolü: retrospektif bir vaka-kontrol çalışması

Abstract

Giriş: Romatoid artrit (RA) hastaları, venöz tromboembolizm (VTE) açısından artmış risk altındadır. Bu çalışma, RA hastalarında VTE ile ilişkili klinik özellikleri ve tedaviyle ilişkili faktörleri belirlemeyi amaçlamaktadır. Yöntemler: VTE'si belgelenmiş 34 RA hastası da dahil olmak üzere 363 RA hastasının retrospektif analizi gerçekleştirilmiştir. Demografik özellikler, eşlik eden hastalıklar ve tedavi verileri, VTE'si olan ve olmayan hastalar arasında karşılaştırılmıştır. VTE'nin bağımsız öngörücülerini belirlemek için yaş ve cinsiyete göre eşleştirilmiş alt grup analizi ve çok değişkenli lojistik regresyon kullanılmıştır. Sonuçlar: VTE'si olan RA hastalarının ortalama yaşı 66,8 (11,5) olup, 30'u (88,2) kadındı. VTE, ileri yaş, hipertansiyon, hiperlipidemi ve daha yüksek Charlson Eşlik Eden Hastalık İndeksi (CCI) ile anlamlı şekilde ilişkiliydi. Çok değişkenli modelde, yüksek CCI, VTE ile bağımsız olarak ilişkiliydi (OR 2,84, %95 GA: 1,46-3,80, p < 0,001). Hidroksiklorokin kullanımı VTE ile negatif ilişkiliydi (OR 0,34, %95 GA: 0,10-0,86, p = 0,049). Diğer DMARD'lar ve glukokortikoidler bağımsız ilişki göstermedi. Sonuç: Yüksek komorbidite yükü, RA hastalarında VTE riskini önemli ölçüde artırırken, hidroksiklorokin koruyucu bir etki gösterebilir. Bu bulgular, kişiye özel komorbidite yönetiminin önemini vurgulamakta ve hidroksiklorokinin RA'da trombozun önlenmesinde potansiyel bir rolü olabileceğini düşündürmektedir.

Keywords

• Romatoid Artrit
• Venöz Tromboembolizim
• Hidroksiklorokin
• Charlson Komorbidite İndexi

Comorbidity burden and the role of hydroxychloroquine in venous thromboembolism risk among rheumatoid arthritis patients: a retrospective case-control study

Abstract

Aims: Patients with rheumatoid arthritis (RA) are at increased risk for venous thromboembolism (VTE). This study aims to identify clinical characteristics and treatment-related factors associated with VTE in RA patients. Methods: A retrospective analysis of 363 RA patients was conducted, including 34 RA patients with documented VTE. Demographics, comorbidities, and treatment data were compared between patients with and without VTE. Age-and sexmatched subgroup analysis and multivariate logistic regression were used to identify independent predictors of VTE. Results: The mean age of RA patients with VTE was 66.8 (11.5) and 30 (88.2) were female. VTE was significantly associated with older age, hypertension, hyperlipidemia, and higher Charlson Comorbidity Index (CCI). In the multivariate model, higher CCI was independently associated with VTE (OR 2.84, 95% CI: 1.46–3.80, p<0.001). Hydroxychloroquine use was negatively associated with VTE (OR 0.34, 95% CI: 0.10–0.86, p=0.049). Other DMARDs and glucocorticoids did not show independent associations. Conclusion: A high comorbidity burden significantly increases VTE risk in RA patients and HCQ use was associated with lower odds of VTE. These findings highlight the importance of individualized comorbidity management and suggest a potential role for hydroxychloroquine in thrombosis prevention in RA.

Keywords

• Rheumatoid arthritis
• venous thromboembolism
• Charlson Comorbidity Index
• hydroxychloroquine

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