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Inflammatory bowel disease: steroid but not biological therapy increases the risk of venous thromboembolic events


Inflammatory bowel disease [ IBD ] is associated with a 1.5- to 3-fold increased risk of venous thromboembolism [ VTE ] events.

Researchers have determined the risk of venous thromboembolism in inflammatory bowel disease as a complication of systemic corticosteroids and anti-tumour necrosis factor alpha [ TNF-alpha ] therapies.

A systematic review and meta-analysis was conducted.

Researchers have identified 817 records, of which eight observational studies, involving 58518 IBD patients, were eligible for quantitative synthesis.

In total, 3260 thromboembolic events occurred.

Systemic corticosteroids were associated with a significantly higher rate of venous thromboembolism complication in IBD patients as compared to IBD patients without steroid medication ( odds ratio [ OR ]: 2.202; 95% confidence interval [ CI ]: 1.698–2.856, p less than 0.001 ).

In contrast, treatment with anti-TNF-alpha agents resulted in a 5-fold decreased risk of venous thromboembolism compared to steroid medication [ OR=0.267; 95% CI: 0.106–0.674, p = 0.005 ].

In conclusion, venous thromboembolism risk should be carefully assessed and considered when deciding between anti-TNF-alpha and steroids in the management of severe flare-ups. ( Xagena )

Sarlos P et al, Journal of Crohn's and Colitis 2018; 12: 489–498

XagenaMedicine_2018



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