Risk of Thromboembolism With IBD Treatments Assessed

Steroid therapy for the management of flare-ups of inflammatory bowel disease (IBD) is associated with an increased risk of venous thromboembolism (VTE), according to the results of a recent study.

In order to examine whether the risk of VTE was affected by the method of therapy for IBD, researchers conducted a systematic review and meta-analysis of 8 observational studies, including data from 58,518 patients.
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Overall, 3260 throboembolic events occurred, with systemic corticosteroid use being associated with a significantly higher rate of VTE complication compared with no steroid use (odds ratio [OR] 2.202). However, treatment with anti-TNFα agents was associated with a 5-fold decreased risk of VTE compared with steroid treatment {OR 0.267).

“These associations highlight the importance of steroid-sparing therapy in IBD, especially in patients with additional risk factors for VTE. The choice between glucocorticoids and anti-TNFα therapy in the management of severe flare-ups should take this into consideration, especially in patients with previous VTE or a family history of thrombotic events,” the researchers concluded.

—Michael Potts

Reference:

Sarlos P, Szemes K, Hegyi P, et al. Steroid but not biological therapy elevates the risk of venous thromboembolic events in inflammatory bowel disease: a meta-analysis. JCC. 2018;12(4):489-498.