Consensus Statements on the Risk, Prevention, and Treatment of Venous Thromboembolism in Inflammatory Bowel Disease: Canadian Association of Gastroenterology

Nguyen, Geoffrey C.; Bernstein, Çharles N.; Bitton, Alain; Chan, Anthony K.C.; Griffiths, Anne M.; Leontiadis, Grigorios I; Geerts, William; Bressler, Brian; Butzner, J. Decker; Carrier, Marc; Chande, Nilesh; Marshall, John K.; Cn, Williams; Kearon, Clive

doi:10.1053/j.gastro.2014.01.042

Cited by 298 publications

(309 citation statements)

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“…The prevalence and incidence rate of VTE in IBD are 1.2-6.7% and 6.3 per 1000 person-years in clinical studies, respectively. 15,41,42 DVT and PE are the most common types of VTE in IBD, but thromboses may also occur at unusual sites such as in cerebrovascular, retinal, portal, mesenteric, splenic or internal jugular veins. 42,43 The association between VTE and disease activity has been well established; at the time of a flare-up, the increase in VTE risk is more prominent.…”

Section: Discussionmentioning

confidence: 99%

“…28,33 However, it is of note that the publication year of all trials is mainly before the implementation of VTE guidelines and consensus statements. 41,54 Finally, if pharmacokinetic measurements had been used in the studies, it would have been possible to determine the plausible effect of drug levels and anti-drug antibodies on VTE risk.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…41,54,55 Anticoagulant thromboprophylaxis is recommended with low-molecular-weight heparin, low-dose unfractioned heparin or fondaparinux. 41 Recently, a risk assessment algorithm for IBD patients at risk of developing VTE has been proposed. 56 Patients with IBD should be stratified according to their general and IBDspecific risk factors for VTE into high-risk and intermediate/lowrisk patients.…”

Section: Discussionmentioning

confidence: 99%

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Steroid but not Biological Therapy Elevates the risk of Venous Thromboembolic Events in Inflammatory Bowel Disease: A Meta-Analysis

Patrícia

Szemes

Hegyi

et al. 2017

Journal of Crohn's and Colitis

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Background and Aims: Inflammatory bowel disease [IBD] is associated with a 1.5-to 3-fold increased risk of venous thromboembolism [VTE] events. The aim of this study was to determine the risk of VTE in IBD as a complication of systemic corticosteroids and anti-tumour necrosis factor alpha [TNFα] therapies. Methods: A systematic review and meta-analysis was conducted, which conforms to the Preferred Reporting Items for Systematic Reviews and Meta-analyses [PRISMA] statement. PubMed, EMBASE, Cochrane Library and Web of Science were searched for English-language studies published from inception inclusive of 15 April 2017. The population-intervention-comparisonoutcome [PICO] format and statistically the random-effects and fixed-effect models were used to compare VTE risk during steroid and anti-TNFα treatment. Quality of the included studies was assessed using the Newcastle-Ottawa scale. The PROSPERO registration number is 42017070084. Results: We identified 817 records, of which eight observational studies, involving 58 518 IBD patients, were eligible for quantitative synthesis. In total, 3260 thromboembolic events occurred. Systemic corticosteroids were associated with a significantly higher rate of VTE 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 < 0.001). In contrast, treatment with anti-TNFα agents resulted in a 5-fold decreased risk of VTE compared to steroid medication [OR: 0.267; 95% CI: 0.106-0.674, p = 0.005]. Conclusion: VTE risk should be carefully assessed and considered when deciding between anti-TNFα and steroids in the management of severe flare-ups. Thromboprophylaxis guidelines should be followed, no matter the therapy choice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Steroid but not Biological Therapy Elevates the risk of Venous Thromboembolic Events in Inflammatory Bowel Disease: A Meta-Analysis

Patrícia

Szemes

Hegyi

et al. 2017

Journal of Crohn's and Colitis

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“…Although all guidelines recommend prophylaxis treatment for in-patients with active CD, it is still not performed systematically in about 50%. Moreover, to date, there are no guidelines about TE prophylaxis to outpatients with CD, except the Canadian Consensus Statements of Venous Thromboembolism in Inflammatory Bowel Disease, 1 which is recommended to outpatients with active CD and prior history of thrombosis. Thus, the aim of this study is to better characterise the clinical features of CD patients with TE and compare it with the current prophylaxis recommendation.…”

mentioning

confidence: 99%

P675. Clinical characteristics of Crohn’s disease and ulcerative colitis patients who switched from an anti-TNF-α agent or natalizumab to vedolizumab or an alternative anti-TNF-α

2016

ECCOJC

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the Romagna Cancer Registry. A data manager matched and then inserted all information in the web-based dedicated database, and then colleagues of Romagna Cancer Registry provided statistical analysis. Results: The total number of IBD cases in Romagna was 1 234, 366 CD cases (184 males and 182 females) and 868 UC cases (502 males and 366 females). In the analysed period, the average annual incidence standardised rate for the European population/100 000 inhabitants was 5.99 for CD males (95% CI 5.08-6.90) and 6.09 for CD females (95% CI 5.14-7.02). For UC it was 14.69 for males (95% CI 13.34-16.02) and 10.82 for females (95% CI 9.62-12). In addition, there were 31 patients with inflammatory bowel disease unclassified. Conclusions: This is the first Italian population-based registry for IBD. Our data seem to confirm the probable underestimated relevance of IBD in Italy described in previous studies. Particularly for CD, incidence is more in accordance with Northern Europe data. We need a longer follow-up for a better validation, especially regarding UC, but in the future, this tool might be an adaptable model to a major reality and very beneficial for a better resource planning in IBD healthcare. P674 Clinical features of thrombosis in patients withCrohn's disease followed at the Clinical

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Things We Do for No Reason™: Withholding pharmacologic venous thromboembolism prophylaxis in hospitalized patients with inflammatory bowel disease

Lee

2023

Journal of Hospital Medicine

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The "Things We Do for No Reason" series reviews practices which have become common parts of hospital care but which may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent "black and white" conclusions or clinical practice standards, but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.

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Consensus Statements on the Risk, Prevention, and Treatment of Venous Thromboembolism in Inflammatory Bowel Disease: Canadian Association of Gastroenterology

Cited by 298 publications

References 93 publications

Steroid but not Biological Therapy Elevates the risk of Venous Thromboembolic Events in Inflammatory Bowel Disease: A Meta-Analysis

Steroid but not Biological Therapy Elevates the risk of Venous Thromboembolic Events in Inflammatory Bowel Disease: A Meta-Analysis

P675. Clinical characteristics of Crohn’s disease and ulcerative colitis patients who switched from an anti-TNF-α agent or natalizumab to vedolizumab or an alternative anti-TNF-α

Things We Do for No Reason™: Withholding pharmacologic venous thromboembolism prophylaxis in hospitalized patients with inflammatory bowel disease

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