Increased Risk of Venous Thromboembolism in Patients With Thyroid Eye Disease Compared to Graves' Disease Without Orbitopathy.

OBJECTIVE

Autoimmune inflammatory disorders have been found to be associated with increased venous thromboembolism (VTE) risk. However, the association between thyroid eye disease (TED) and systemic thrombotic events has not been characterized. This study evaluated whether TED is associated with increased VTE risk compared to Graves' disease without ocular involvement.

METHODS

This retrospective propensity score-matched cohort study used the TriNetX Global Collaborative Network. Adult patients with TED were matched 1:1 with patients with Graves' disease without TED based on demographics, comorbidities, medications, and body mass index. Patients receiving teprotumumab were excluded. The primary outcome was incident VTE, defined as pulmonary embolism or deep vein thrombosis occurring after the index date. Secondary outcomes included pulmonary embolism, deep vein thrombosis, and retinal vein occlusion. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.

RESULTS

After propensity score matching, 19 320 patients per cohort were included with mean follow-up of 4.7 years. TED was associated with increased risk of incident VTE compared to Graves' disease without TED (2.6% vs 2.2%; HR, 1.20; 95% CI, 1.05-1.37; P = .007). TED was also associated with increased risk of pulmonary embolism (1.4% vs 1.1%; HR, 1.22; 95% CI, 1.02-1.47; P = .03). Associations with deep vein thrombosis and retinal vein occlusion were not statistically significant.

CONCLUSIONS

TED is associated with increased systemic thrombotic risk independent of traditional VTE risk factors. These findings highlight the systemic implications of TED and suggest that thrombotic risk should be considered in the clinical evaluation and management of affected patients.