Immunosuppressive drugs for nontransplant comorbidities are not associated with abdominal aortic aneurysm growth

Thanigaimani, Shivshankar, Phie, James, Quigley, Frank, Bourke, Michael, Bourke, Bernie, Velu, Ramesh, Jenkins, Jason, and Golledge, Jonathan (2022) Immunosuppressive drugs for nontransplant comorbidities are not associated with abdominal aortic aneurysm growth. JVS: Vascular Science, 3. pp. 306-313.

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Background: In the present study, we examined the association of immunosuppressant drug prescriptions with the growth of small abdominal aortic aneurysms (AAAs).

Methods: Participants with an AAA measuring between 30 and 50 mm were recruited from four Australian centers. AAA growth was monitored by ultrasound. The immunosuppressant drugs included conventional disease-modifying antirheumatic drugs (eg, methotrexate, sulfasalazine, leflunomide), steroids, hydroxychloroquine, other immunosuppressant drugs (eg, cyclosporine, azacitidine), or a combination of these drugs. Linear mixed effects modeling was performed to examine the independent association of an immunosuppressant prescription with AAA growth. A subanalysis examined the association of steroids with AAA growth.

Results: Of the 621 patients, 34 (5.3%) had been prescribed at least one (n = 26) or more (n = 8) immunosuppressant drug and had been followed up for a median period of 2.1 years (interquartile range, 1.1-3.5 years), with a median of three ultrasound scans (interquartile range, two to five ultrasound scans). No significant difference was found in AAA growth when stratified by a prescription of immunosuppressant drugs on either unadjusted (mean difference, 0.2 mm/y; 95% confidence interval [CI], −0.4 to 0.7; P =.589) or risk factor-adjusted (mean difference, 0.2 mm/y; 95% CI, −0.3 to 0.7; P =.369) analyses. The findings were similar for the unadjusted (mean difference, 0.0 mm/y; 95% CI, −0.7 to 0.7; P =.980) and risk factor-adjusted (mean difference, 0.1 mm/y; 95% CI, −0.6 to 0.7; P =.886) subanalyses focused on steroid use.

Conclusions: The results from this study suggest that AAA growth is not affected by immunosuppressant drug prescription. Studies with larger sample sizes are needed before reliable conclusions can be drawn.

Item ID: 77688
Item Type: Article (Research - C1)
ISSN: 2666-3503
Keywords: AAA growth, Abdominal aortic aneurysm, Immunosuppression, Linear mixed effects modeling
Copyright Information: © 2022 Published by Elsevier Inc. on behalf of the Society for Vascular Surgery. This is an open access article under the CC BY-NC-ND license (
Date Deposited: 15 Feb 2023 00:12
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3214 Pharmacology and pharmaceutical sciences > 321402 Clinical pharmacology and therapeutics @ 50%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200102 Efficacy of medications @ 50%
20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 50%
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