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Current Treatment Options in Gastroenterology
Published in: Current Treatment Options in Gastroenterology 3/2020

01-09-2020 | Venous Thrombosis | Inflammatory Bowel Disease (G Lichtenstein, Section Editor)

Inflammatory Bowel Disease Therapy and Venous Thromboembolism

Authors: Thomas Lambin, MD, Adam S. Faye, MD, Jean-Frédéric Colombel, MD

Published in: Current Treatment Options in Gastroenterology | Issue 3/2020

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Abstract

Purpose of review

To explore the relationship between IBD (inflammatory bowel diseases) therapy and VTE (venous thromboembolism) risk, as well as the safety, barriers, and utility of VTE prophylaxis.

Recent findings

In 2019, the Food and Drug Administration (FDA) issued a black box warning concerning the use of tofacitinib among ulcerative colitis (UC) patients with a post hoc analysis revealing that all patients had additional risk factors for VTE. Additionally, although IBD patients experiencing a disease flare often present with hematochezia, these patients are less likely to receive VTE prophylaxis, despite data showing that pharmacologic prophylaxis has not been associated with clinically significant signs of bleeding.

Summary

Among IBD patients, corticosteroid use has been associated with an increased risk of VTE, whereas anti-TNF therapy does not appear to increase this risk. High-dose tofacitinib has also been shown to increase the likelihood of VTE in patients with additional risk factors. In order to prevent future VTE events, pharmacologic thromboprophylaxis should be emphasized, particularly in hospitalized IBD patients, with recent data suggesting that a select population at risk may benefit from continued prophylaxis.
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Metadata
Title
Inflammatory Bowel Disease Therapy and Venous Thromboembolism
Authors
Thomas Lambin, MD
Adam S. Faye, MD
Jean-Frédéric Colombel, MD
Publication date
01-09-2020
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 3/2020
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-020-00304-z

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