There have been long-standing connections between autoimmune and chronic inflammatory conditions and VTE based on the spectrum of either systemic inflammation or endothelial damage and coagulation dysfunctions. Yet the link between AS and VTE remains unclear. The study systematically searched PubMed, Embase, Cochrane Library, and Web of Science from database commencement until June 2025. It comprised six observational studies that fulfilled specific inclusion criteria. It analyzed data from a total of 601585 participants. Two authors independently selected and extracted data.
They used the RoBINS-I assessment method to determine risk of bias. It calculated and combined adjusted hazard ratios (HRs) with their 95% confidence intervals (CIs) with RevMan Computer Software Version 5.3. They registered its protocol in PROSPERO (CRD420251107387) after completion and made a GRADE assessment of its body of evidence.
Key findings:
The pooled analysis demonstrated that ankylosing spondylitis was associated with a 47% higher risk of VTE compared with controls (HR = 1.47; 95% CI, 1.22–1.77; P < 0.0001), although the overall certainty of evidence was rated as very low due to the observational nature of the data.
Subgroup analyses further clarified this association, showing a consistent increase in risk across different thrombotic outcomes.
When individual VTE components were examined, AS was associated with a 57% increased risk of overall VTE (HR = 1.57; 95% CI, 1.26–1.96; P < 0.0001).
The risk of deep vein thrombosis was increased by 62% (HR = 1.62; 95% CI, 1.16–2.26; P = 0.005), while the risk of pulmonary embolism was elevated by 24% (HR = 1.24; 95% CI, 1.06–1.45; P = 0.008).
Sensitivity analyses confirmed the robustness of these findings, and no major publication bias was evident on funnel plot inspection.
Current evidence suggests that ankylosing spondylitis is associated with an increased risk of venous thromboembolism, though further mechanistic studies are needed to clarify and interpret findings from observational data. Although these findings support closer clinical awareness of thrombotic risk in AS, further prospective and mechanistic studies are needed to confirm causality and determine whether targeted prevention strategies may improve outcomes in this population.
Reference:
Hu, Q., Mei, M., Liu, R., & Zhang, Q. (2025). The association between ankylosing spondylitis and the risk of venous thromboembolism: a meta-analysis. Frontiers in immunology, 16, 1670965. https://doi.org/10.3389/fimmu.2025.1670965
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.