Multiple Sclerosis and the Incidence of Venous Thromboembolism: A Systematic Review and Meta-Analysis Publisher Pubmed



Ghoshouni H¹ ; Shafaei B¹ ; Farzan M¹ ; Hashemi SM¹ ; Afsharisafavi A² ; Ghaffary EM¹ ; Mohammadzamani M¹ ; Shaygannejad V^{1, 2} ; Shamloo AS⁴ ; Mirmosayyeb O^{1, 2, 3} Show Affiliations
Source: Journal of Thrombosis and Thrombolysis Published:2023

Abstract

A number of studies have suggested that multiple sclerosis (MS) can be associated with serious vascular complications, for which pulmonary thromboembolism (PTE) is a potentially lethal complication. The purpose of this study is to establish a current literature-based estimate of the incidence of venous thromboembolism (VTE), deep vein thrombosis (DVT), and PTE in patients with MS (pwMS) due to the lack of systematic reviews and meta-analyses on this topic. In this systematic review and meta-analysis, studies were assessed regarding the association between MS and the incidence of VTE. The studies were identified through a systematic search of major electronic databases spanning the period from 1950 to February 2022. A random-effects analysis was conducted to calculate the pooled effect size (ES) and 95% confidence intervals (CI) using STATA software. Nine out of 4605 studies were included in the meta-analysis, with an overall sample size of 158,546 individuals. Meta-analysis revealed that the pooled incidence of VTE was 1.8% (95% CI 1.4–2.3) among pwMS. Also, there was an incidence of 0.9% (95% CI 0.4–1.4) and 1.5% (95% CI 1–2.2) for PTE and DVT, respectively in pwMS. Analysis showed MS would be significantly associated with a twofold increased risk of VTE [risk ratios (RR) = 2.12 (95% CI 1.53–2.93)]. Although MS is not typically considered a major risk factor for VTE, the meta-analysis of cohort studies shows that MS has a relative association with an increased incidence of VTE. Future research should focus on the investigation of the effects of MS and its treatments on VTE risk, and also a full range of confounding adjustments will be needed. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.