Lupus Sci Med. 2026 Aug 6;13(2):e002058. doi: 10.1136/lupus-2026-002058.
ABSTRACT
OBJECTIVES: To estimate the risk of venous thromboembolism (VTE) in a nationwide cohort of newly diagnosed patients with SLE and in a cohort of established patients with SLE at Karolinska University Hospital compared with the general population.
METHODS: Individuals with SLE were identified from the National Patient Register and matched to general population comparators on age, sex and residence. Follow-up was from diagnosis/matching until incident VTE, death, emigration or study end. The Karolinska cohort was followed from enrolment and additionally stratified by lupus nephritis (LN) and antiphospholipid antibody (aPL) positivity. Incidence rates (IR) of VTE were estimated and adjusted HRs with 95% CIs were estimated using Cox models. Time-dependent adjusted HRs were estimated using flexible parametric survival models.
RESULTS: In the nationwide cohort (N=4335), the mean age at inclusion was 49 years, 83% were female and mean follow-up was 7.4 years. The VTE IR was 8.8 per 1000 person-years compared with 2.8 in comparators, corresponding to an HR of 3.3 (95% CI 2.9 to 3.8). In the Karolinska cohort (N=784), the HR was 4.9 (95% CI 3.7 to 6.5). VTE risk was highest in the first few years after SLE diagnosis. LN was not significantly associated with VTE, and aPL positivity was associated with a 60% higher hazard, which was non-significant and attenuated after excluding individuals with prior VTE.
CONCLUSION: SLE is associated with an over threefold increased risk of VTE, in particular soon after SLE diagnosis, underscoring the need for individualised VTE risk assessment.
PMID:42562426 | DOI:10.1136/lupus-2026-002058