Venous thromboembolism in Cushing syndrome : results from an EuRRECa and Endo-ERN survey
Cherenko, Mariya (Leiden University Medical Centre (Leiden, Països Baixos))
Appelman-Dijkstra, Natasha M. (Leiden University Medical Centre (Leiden, Països Baixos))
Zurita, Ana Luisa Priego (Leiden University Medical Centre (Leiden, Països Baixos))
Biermasz, Nienke R. (Leiden University Medical Centre (Leiden, Països Baixos))
Dekkers, Olaf M. (Leiden University Medical Centre (Leiden, Països Baixos))
Klok, F.A. (Leiden University Medical Centre (Leiden, Països Baixos))
Reisch, Nicole (LMU University Hospital. LMU Munich)
Aulinas, Anna (Institut de Recerca Sant Pau)
Biagetti, Betina (Hospital Universitari Vall d'Hebron)
Cannavo, Salvatore (University Hospital AOU Policlinico G. Martino)
Canu, L. (Careggi University Hospital (Florència, Itàlia))
Detomas, Mario (University Hospital Würzburg)
Devuyst, France (Hôpital Universitaire de Bruxelles)
Falhammar, Henrik (Karolinska Institutet (Estocolm, Suècia))
Feelders, Richard Abraham (Erasmus Medical Center)
Ferrau, Francesco (University Hospital AOU Policlinico G. Martino)
Gatto, Federico (IRCCS Ospedale Policlinico San Martino (Gènova, Itàlia))
Grasselli, Chiara (Azienda Unità Sanitaria Locale di Reggio Emilia. Instituto in tecnologie avanzate e modelli assistenziali in oncologia)
van Houten, Pepijn (Radboud University Medical Center)
Hoybye, Charlotte (Karolinska Institutet (Estocolm, Suècia))
Isidori, Andrea M. (Università degli Studi di Roma "La Sapienza")
Kyrilli, Aglaia (Hôpital Universitaire de Bruxelles)
Loli, Paola (Istituto di Ricovero e Cura A Carattere Scientifico (IRCCS))
Maiter, Dominique (Cliniques universitaires Saint-Luc - UCLouvain)
Nowak, Elisabeth (LMU University Hospital)
Pivonello, Rosario (Università degli studi di Napoli Federico II)
Ragnarsson, Oskar (University of Gothenburg)
Steenaard, Rebecca V. (Máxima MC)
Unger, Nicole (University Hospital Essen (Alemanya))
van de Ven, A. (Istituto di Ricovero e Cura A Carattere Scientifico (IRCCS))
Webb, S. M. 1952- (Institut de Recerca Sant Pau)
Yeste Fernández, Diego (Hospital Universitari Vall d'Hebron)
Ahmed, S. Faisal (University of Glasgow)
Pereira, Alberto M. (Amsterdam University Medical Centre)
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	Background: Patients with Cushing syndrome (CS) are at increased risk of venous thromboembolism (VTE). Objective: The aim was to evaluate the current management of new cases of CS with a focus on VTE and thromboprophylaxis. Design and methods: A survey was conducted within those that report in the electronic reporting tool (e-REC) of the European Registries for Rare Endocrine Conditions (EuRRECa) and the involved main thematic groups (MTG's) of the European Reference Networks for Rare Endocrine Disorders (Endo-ERN) on new patients with CS from January 2021 to July 2022. Results: Of 222 patients (mean age 44 years, 165 females), 141 patients had Cushing disease (64%), 69 adrenal CS (31%), and 12 patients with ectopic CS (5. 4%). The mean follow-up period post-CS diagnosis was 15 months (range 3-30). Cortisol-lowering medications were initiated in 38% of patients. One hundred fifty-four patients (69%) received thromboprophylaxis (including patients on chronic anticoagulant treatment), of which low-molecular-weight heparins were used in 96% of cases. VTE was reported in six patients (2. 7%), of which one was fatal: two long before CS diagnosis, two between diagnosis and surgery, and two postoperatively. Three patients were using thromboprophylaxis at time of the VTE diagnosis. The incidence rate of VTE in patients after Cushing syndrome diagnosis in our study cohort was 14. 6 (95% CI 5. 5; 38. 6) per 1000 person-years. Conclusion: Thirty percent of patients with CS did not receive preoperative thromboprophylaxis during their active disease stage, and half of the VTE cases even occurred during this stage despite thromboprophylaxis. Prospective trials to establish the optimal thromboprophylaxis strategy in CS patients are highly needed. Significance statement The incidence rate of venous thromboembolism in our study cohort was 14. 6 (95% CI 5. 5; 38. 6) per 1000 person-years. Notably, this survey showed that there is great heterogeneity regarding time of initiation and duration of thromboprophylaxis in expert centers throughout Europe.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Cushing disease ; Cushing syndrome ; Endogenous hypercortisolism ; Thromboprophylaxis ; Venous thromboembolism
Publicado en:	Endocrine Connections, Vol. 13 Núm. 6 (JUN 2024) , p. e240046, ISSN 2049-3614

DOI: 10.1530/EC-24-0046
PMID: 38614126

10 p, 1.4 MB

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