Increased incidence of deep venous thrombosis in ALS.

摘要

The annual incidence of deep venous thrombosis (DVT) is approximately 0.1% in the general population, 1.3% in hospitalized patients, and 1.8% among the elderly between 65 and 69 years old.1,2 Pulmonary embolism (PE) subsequently develops in 25% of individuals, with a 15 to 20% mortality rate.1 There are few data concerning venous thromboembolism in ALS and other neuromus-cular disorders. We examined the occurrence of symptomatic DVT in patients with ALS enrolled in the placebo-controlled, double-blind clinical trials of topiramate, creatine, and celecoxib performed by the Northeast ALS (NEALS) Consortium from 1998 to 20043-5 {see table E-l on the Neurology Web site at www.neurology.org). Methods. Seven hundred patients with ALS were enrolled in three studies: 296 in the topiramate trial, 104 in the creatine trial, and 300 in. the celecoxib trial. We excluded patients receiving topiramate because 6% of patients given topiramate, vs 1% of patients given placebo, had an episode of DVT or PE.3 The increased incidence of DVT was attributed to the use of topiramate. Measures of disease progression in all trials included the Amyo-trophic Lateral Sclerosis Functional Rating Scale (ALSFRS), percent-predicted vital capacity (%VC), and quantitative muscle testing of arm and grip strength using the maximum voluntary isometric contraction (MVIC). In addition, leg strength was measured in the celecoxib trial.