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To the Editor: Dr Bosch and colleagues¹ conducted a systematic review of treatment of antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis, including Wegener granulomatosis. However, their article did not discuss the increased incidence of thromboembolic events in patients with Wegener granulomatosis and the possible role of anticoagulation in these patients.

The incidence of thromboembolic events in Wegener granulomatosis is as high as in patients with previous idiopathic venous thromboembolism (7.0 cases/ 100 patient-years vs 7.2 cases/100 patient-years, respectively).^2-3 Considering that prophylactic use of warfarin is an effective method of preventing thromboembolic events in patients with previous idiopathic venous thromboembolism,^3-4 it is possible that prophylactic anticoagulation may also have a role in patients with Wegener granulomatosis who have no contraindications to warfarin. This may be especially important during disease activity because 81% of thromboembolic events in persons with active Wegener granulomatosis occur during this phase.² However, this would need to be addressed by . . . [Full Text of this Article]

Alfredo N. C. Santana, MD
alfredonicodemos@hotmail.com

Telma Antunes, PhD; Carmen S. V. Barbas, PhD
University of Saõ Paulo Medical School
Saõ Paulo, Brazil

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