TOPLINE

Patients with systemic lupus erythematosus (SLE) had a more than threefold higher risk for venous thromboembolism (VTE) than individuals from the general population, with the risk particularly elevated during the first year following diagnosis and remained elevated over time.

METHODOLOGY

• Researchers conducted a matched cohort study using data from Swedish health registers and a clinical cohort from a hospital to compare the risk for VTE in adults with newly diagnosed SLE and established SLE with that in the general population.
• The nationwide cohort included 4335 adults with SLE (mean age, 49.2 years; 82.7% women) and 43,042 matched individuals from the general population. The mean follow-up duration was 7.5 and 8.2 years, respectively.
• A separate Karolinska University Hospital cohort included 784 patients with SLE (mean age, 45.5 years; 85.6% women) and 7471 matched individuals from the general population. The mean follow-up duration was 9.4 and 10.4 years, respectively.
• Patients in the Karolinska cohort were additionally stratified by the history of lupus nephritis and antiphospholipid (aPL) antibody positivity.
• The primary outcome was the first occurrence of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE).

TAKEAWAY

• In the nationwide cohort, patients with SLE had a more than threefold higher risk for VTE than individuals from the general population (hazard ratio [HR], 3.3; 95% CI, 2.9-3.8), with similar elevations for PE and DVT.
• In the Karolinska cohort, patients with SLE had nearly a fivefold higher risk for VTE than individuals from the general population (HR, 4.9; 95% CI, 3.7-6.5), with similar elevations for PE and DVT.
• The risk for VTE was highest during the first year after the diagnosis of SLE, with a 4.1-fold higher risk declining to 2.2-fold at 10 years in the nationwide cohort. The Karolinska cohort showed a similar pattern.
• In the Karolinska cohort, patients who were positive for aPL antibodies had a more than twofold higher risk for DVT than those who were negative for aPL antibodies; lupus nephritis was not significantly associated with the risk for VTE.

IN PRACTICE

"The increased risk in the first year after diagnosis highlights a time period where preventative measures like prophylactic anticoagulant treatment could be taken, underscoring the importance of risk stratification," the authors wrote.

SOURCE

This study was led by Tamara Vojinovic, University of Genoa, Genoa, Italy. It was published online on August 06, 2026, in Lupus Science & Medicine.

LIMITATIONS

The study may have missed VTE events that occurred before SLE was diagnosed or between the first and second SLE visits. Smoking, obesity, and immobility were not fully captured. The inclusion of patients with prevalent SLE in the Karolinska cohort may have introduced survival bias.

DISCLOSURES

The study was supported by multiple sources, including the Swedish Research Council, the Swedish Heart Lung Foundation, and the Stockholm County Council. The authors did not declare any competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.