Characterising the treatment of thromboembolic events after COVID-19 vaccination in 4 European countries and the US: an international network cohort study

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• dc.contributor.author Markus, Aniek F.
• dc.contributor.author Strauss, Victoria Y.
• dc.contributor.author Burn, Edward
• dc.contributor.author Li, Xintong
• dc.contributor.author Delmestri, Antonella
• dc.contributor.author Reich, Christian
• dc.contributor.author Yin, Can
• dc.contributor.author Mayer, Miguel Ángel, 1960-
• dc.contributor.author Ramírez Anguita, Juan Manuel
• dc.contributor.author Marti, Edelmira
• dc.contributor.author Verhamme, Katia M. C.
• dc.contributor.author Rijnbeek, Peter
• dc.contributor.author Prieto-Alhambra, Daniel
• dc.contributor.author Jödicke, Annika M.
• dc.date.accessioned 2023-09-19T06:09:46Z
• dc.date.available 2023-09-19T06:09:46Z
• dc.date.issued 2023
• dc.description.abstract Background: Thrombosis with thrombocytopenia syndrome (TTS) has been identified as a rare adverse event following some COVID-19 vaccines. Various guidelines have been issued on the treatment of TTS. We aimed to characterize the treatment of TTS and other thromboembolic events (venous thromboembolism (VTE), and arterial thromboembolism (ATE) after COVID-19 vaccination and compared to historical (pre-vaccination) data in Europe and the US. Methods: We conducted an international network cohort study using 8 primary care, outpatient, and inpatient databases from France, Germany, Netherlands, Spain, The United Kingdom, and The United States. We investigated treatment pathways after the diagnosis of TTS, VTE, or ATE for a pre-vaccination (background) cohort (01/2017-11/2020), and a vaccinated cohort of people followed for 28 days after a dose of any COVID-19 vaccine recorded from 12/2020 onwards). Results: Great variability was observed in the proportion of people treated (with any recommended therapy) across databases, both before and after vaccination. Most patients with TTS received heparins, platelet aggregation inhibitors, or direct Xa inhibitors. The majority of VTE patients (before and after vaccination) were first treated with heparins in inpatient settings and direct Xa inhibitors in outpatient settings. In ATE patients, treatments were also similar before and after vaccinations, with platelet aggregation inhibitors prescribed most frequently. Inpatient and claims data also showed substantial heparin use. Conclusion: TTS, VTE, and ATE after COVID-19 vaccination were treated similarly to background events. Heparin use post-vaccine TTS suggests most events were not identified as vaccine-induced thrombosis with thrombocytopenia by the treating clinicians.
• dc.format.mimetype application/pdf
• dc.identifier.citation Markus AF, Strauss VY, Burn E, Li X, Delmestri A, Reich C, Yin C, Mayer MA, Ramírez-Anguita JM, Marti E, Verhamme MC, Rijnbeek PR, Prieto-Alhambra D, Jödicke AM. Characterising the treatment of thromboembolic events after COVID-19 vaccination in 4 European countries and the US: an international network cohort study. Front Pharmacol. 2023;14:1118203. DOI: 10.3389/fphar.2023.1118203
• dc.identifier.doi http://dx.doi.org/10.3389/fphar.2023.1118203
• dc.identifier.issn 1663-9812
• dc.identifier.uri http://hdl.handle.net/10230/57907
• dc.language.iso eng
• dc.publisher Frontiers
• dc.relation.ispartof Front Pharmacol. 2023;14:1118203
• dc.rights © 2023 Markus, Strauss, Burn, Li, Delmestri, Reich, Yin, Mayer, RamírezAnguita, Marti, Verhamme, Rijnbeek, Prieto-Alhambra and Jödicke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword COVID-19
• dc.subject.keyword Anticoagulation
• dc.subject.keyword Drug utilization
• dc.subject.keyword Epidemiology
• dc.subject.keyword Thromboembolic events
• dc.subject.keyword Treatment pathways
• dc.subject.keyword Vaccination
• dc.title Characterising the treatment of thromboembolic events after COVID-19 vaccination in 4 European countries and the US: an international network cohort study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion