In patients with fetal and neonatal alloimmune thrombocytopenia (FNAIT), treatment with intravenous immunoglobulin (IVIG) may be associated with the development of venous thromboembolism/pulmonary embolism (VTE/PE), according to a study recently published in Blood, and certain indicators may increase this risk.
The researchers sought to assess the predictors, incidence and outcomes associated with the occurrence of VTE/PE among IVIG-treated individuals to help optimize management and outcomes among these individuals.
Over the study period, a total of 40,670 patients underwent treatment with IVIG. Overall, 2.2% of these individuals experienced VTE/PE.
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Obesity and neurological disorders may be predictors of VTE/PE
Statistically significant predictors of VTE/PE included the following:
- Obesity
- Presence of a neurological disorder
A history of alcohol abuse increased the risk for VTE/PE as well, although not significantly. In addition, a prior diagnosis of chronic lung disease, liver disease, congestive heart failure, hypertension, or diabetes was associated with a decreased risk for VTE/PE.
Regarding race and gender, African American and Hispanic patients who received IVIG treatment had a lower risk for VTE/PE compared with White patients.
The use of IVIG was associated with hospital-related factors as well. In fact, those patients treated in larger hospitals and in urban teaching hospitals exhibited a significantly increased risk for VTE/PE. This may be because more medically complex patients undergo treatment in larger teaching hospitals.
Those patients who developed VTE/PE experienced significantly worse in-hospital outcomes compared with those who did not experience VTE/PE. The median length of hospital stay was 13 days among patients in the VTE/PE arm, versus four days among those in the non- VTE/PE arm.
“These results emphasize the importance of continuing close monitoring of VTE/PE in the setting of IVIG therapy, along with tailored management strategies intended to minimize adverse outcomes and improve overall care,” the authors concluded.
