Increased Risk for Pulmonary Embolism among Patients with Ankylosing Spondylitis—Results from a Large Database Analysis

Omer Gendelman, Neta Simon, Niv Ben-Shabat, Yonatan Shneor Patt, Dennis McGonagle, Arnon Dov Cohen, Howard Amital, Abdulla Watad

    Research output: Contribution to journalArticlepeer-review


    Background: Axial spondyloarthropathy(AS) is a chronic inflammatory disease primarily affecting the axial skeleton, often characterized by sacroiliitis. While pulmonary embolism (PE), a potentially lethal condition, has been linked to several autoimmune diseases, limited data exist regarding PE risk among patients with AS. Methods: This retrospective cohort study utilized the Clalit Healthcare Services (CHS) database, including 5825 patients with AS and 28,356 matched controls. Follow-up began at the date of first AS diagnosis for patients and at the matched patient’s diagnosis date for controls and continued until PE diagnosis, death, or study end date. Results: Prevalence of PE before AS diagnosis in patients compared to controls was 0.4% vs. 0.2% (p < 0.01). The incidence rate of PE was 11.6 per 10,000 person-years for patients with AS and 6.8 per 10,000 person-years for controls. The adjusted hazard ratio (HR) for PE in patients with AS was 1.70 (p < 0.001). Subgroup analysis demonstrated excess risk for PE in patients with AS regardless of gender and age, with variations among AS treatment categories. Discussion: Our findings highlight a significant association between AS and PE, indicating an increased risk in patients with AS independent of age and sex and suggests a subclinical level of inflammation. Preliminary results suggest a protective role of immunosuppressing drugs. Further research into the impact of treatment strategies should be conducted and could inform clinical management and reduce the life-threatening risk of PE in Patients with AS.

    Original languageEnglish
    Article number2790
    JournalJournal of Clinical Medicine
    Issue number10
    StatePublished - 1 May 2024


    • ankylosing spondylitis
    • epidemiology
    • pulmonary embolism
    • real world evidence
    • registries

    ASJC Scopus subject areas

    • General Medicine


    Dive into the research topics of 'Increased Risk for Pulmonary Embolism among Patients with Ankylosing Spondylitis—Results from a Large Database Analysis'. Together they form a unique fingerprint.

    Cite this