Extensive forearm deep venous thrombosis following a severe infliximab infusion reaction

Ryan, Barbara; Romberg, Marielle; Wolters, Frank; Stockbrügger, Reinhold W.

doi:10.1097/00042737-200409000-00022

Cited by 22 publications

(12 citation statements)

References 10 publications

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“…66 In spite of these potential anticoagulant effects of TNF-a blockade, there are case reports of thromboses at venous infusion sites, retinal vein, pulmonary thromboembolism, paroxysmal nocturnal hemoglobinuria with Budd Chiari syndrome, and cerebrovascular accidents in patients receiving anti-TNF-a therapy. 67,68 Thus, it seems that this putative anticoagulant effect should not lead to complacency in monitoring for patients for VTE.…”

Section: Infliximab and Adalimumabmentioning

confidence: 99%

Thrombosis and inflammatory bowel disease: A call for improved awareness and prevention

Zitomersky

Verhave

Trenor

2011

Inflammatory Bowel Diseases

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Thrombotic complications in patients with inflammatory bowel disease (IBD) are common and require improved awareness and prevention. In this review the interface between IBD and thrombosis is discussed, with emphasis on risk assessment and data to aid clinical decision making. Thromboembolic complications are 3-fold more likely in IBD patients than controls and the relative risk exceeds 15 during disease flares. Improved assessment of thrombosis risk for an individual patient includes thorough personal and family history and awareness of prothrombotic medications and lifestyle choices. Patients with the highest risk of thrombosis are those with active colonic disease, personal or strong family history of thrombosis, and those with significant acquired risk factors. Combined risk factors or hospitalization should prompt mechanical thromboprophylaxis. Indications for prophylactic anticoagulation are not defined currently by clinical studies, especially in pediatric patients, although some groups now advocate prophylactic anticoagulation for all hospitalized IBD patients and even some outpatients with disease flares. Thrombosis management requires a multidisciplinary therapeutic approach to balance anticoagulation and bleeding risk. While bleeding may occur with anticoagulation in IBD, data and experience indicate that therapeutic heparin is safe and bleeding manifestations can be managed supportively in most patients. Until prospective trials of prophylactic anticoagulation are published, management of thrombotic risk and prophylaxis in IBD will remain a clinical challenge.

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Section: Infliximab and Adalimumabmentioning

confidence: 99%

Thrombosis and inflammatory bowel disease: A call for improved awareness and prevention

Zitomersky

Verhave

Trenor

2011

Inflammatory Bowel Diseases

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“…In fact, TNF-α antagonists may improve endothelial dysfunction, lipid profile, homocysteine concentration, insulin action, and subclinical atherosclerosis and thus decrease cardiovascular events in RA patients [25,26,37,49]. Despite controversed, this beneficial effect on endothelial dysfunction might be transient [7,27] and, severe punctual arterial and venous TE have been described [1,8,12,19,28,44,46,52] during anti-TNF therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, several cases of arterial and/or venous thrombo-embolic events (TE) [1,8,12,19,28,44,46,52], and more recently vasculitides [11], have been recently reported during TNF-α inhibition.…”

Section: Introductionmentioning

confidence: 99%

Arterial and venous thromboembolic events during anti-TNF therapy: A study of 85 spontaneous reports in the period 2000–2006

Petitpain¹,

Gambier²,

Wahl

et al. 2009

Bio-Medical Materials and Engineering

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Background: Systemic inflammation such as rheumatoid arthritis (RA) and Crohn's disease (CD) may be responsible for vascular comorbidity. TNF-α blockade was expected to lower these comorbidities but several cases of arterial and venous thromboembolic events (TE) have been reported.Objectives: The aim of this work was to study retrospectively the main characteristics of spontaneously notified TNF-α blockers related TE over a 7-year period.Methods: TE related to infliximab, etanercept and adalimumab spontaneously notified to the French adverse drug reporting system database between January 2000 and December 2006 were analyzed. Separate analysis of arterial TE and venous TE was performed. Risk factors for each category of TE were assessed with consensual criteria.Results: 85 TE were analyzed, representing 4.5% of all the spontaneously notified adverse reactions of the 3 TNF-α blockers in the database. 42 were arterial events and 43 were venous events. The incidence was not significantly different between the 3 TNF-α blockers. Mean delay of TE onset after treatment initiation was 10.6 months. It was significantly shorter for etanercept (6.1 months, p = 0.001) especially for venous TE (2.4 months). 16 among the 42 patients with arterial TE had 2 or more risk factors whereas 39 among the 43 patients with venous TE had no RF or only one. Most of patients (79/85) received concomitant systemic corticosteroids and/or methotrexate and/or COX-2 selective inhibitors. 23 patients had been investigated for autoimmunity, 13 had antinuclear and/or antiphospholipid antibodies. Main limitations of this study were underreporting and heterogeneous report contents.Conclusion: Despite its limitations, this study suggests that venous TE could be favoured by TNF-α blockers therapy since they occurred in patients with no or few risk factors for venous thrombosis. However, this needs to be more evaluated by controlled studies.

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“…In addition to improvements in rheumatologic symptoms, this treatment also resulted in improvements in fibrinolytic balance (reduced PAI-1) providing indirect evidence of a reduced thrombotic profile [120]. However, hypersensitivity reactions and venous thrombosis have been reported with infliximab treatment [121]. Another clinically-available TNF-inhibitor, enbrel/etanercept, has been prescribed to patients with rheumatoid arthritis.…”

Section: Tnf-alphamentioning

confidence: 99%

Strategies to Reduce Vascular Risk Associated with Obesity

Bodary

Iglay

Eitzman

2007

CVP

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The obesity pandemic will likely have a significant impact on the global incidence of cardiovascular disease. Although the mechanisms linking obesity and cardiovascular disease are unclear, recent studies have implicated the adipocyte as a potentially important mediator of vascular complications. The adipocyte is no longer considered a passive storage depot for triglycerides and fatty acids, but rather an active metabolic organ capable of producing several factors, commonly referred to as adipokines, that may have effects on many physiological and pathophysiological processes. With increasing fat mass, several adipose-related factors are upregulated that may affect local and distant inflammatory processes, including atherothrombosis. Other factors, such as adiponectin, are downregulated with increasing fat mass. Although most adipokines are thought to promote vascular disease, several studies over the past few years indicate adiponectin is actually protective against both diabetes and vascular disease. There are now available pharmacologic agents capable of altering the adipocyte transcription profile. This review will focus on the potential impact of adipocyte-derived factors towards vascular disease and emerging therapeutic strategies that may alter these effects.

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Extensive forearm deep venous thrombosis following a severe infliximab infusion reaction

Cited by 22 publications

References 10 publications

Thrombosis and inflammatory bowel disease: A call for improved awareness and prevention

Thrombosis and inflammatory bowel disease: A call for improved awareness and prevention

Arterial and venous thromboembolic events during anti-TNF therapy: A study of 85 spontaneous reports in the period 2000–2006

Strategies to Reduce Vascular Risk Associated with Obesity

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