Steroid but not biological therapy elevates the risk of venous thromboembolic events in inflammatory bowel disease: A meta-analysis

Patricia Sarlos, Kata Szemes, Peter Hegyi, Andras Garami, Imre Szabo, Anita Illes, Margit Solymar, Erika Petervari, Aron Vincze, Gabriella Par, Judit Bajor, Jozsef Czimmer, Orsolya Huszar, Peter Varju, Nelli Farkas

Research output: Review article

21 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)489-498
Number of pages10
JournalJournal of Crohn's and Colitis
Volume12
Issue number4
DOIs
Publication statusPublished - ápr. 2018

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Steroid but not biological therapy elevates the risk of venous thromboembolic events in inflammatory bowel disease: A meta-analysis'. Together they form a unique fingerprint.

  • Cite this

    Sarlos, P., Szemes, K., Hegyi, P., Garami, A., Szabo, I., Illes, A., Solymar, M., Petervari, E., Vincze, A., Par, G., Bajor, J., Czimmer, J., Huszar, O., Varju, P., & Farkas, N. (2018). Steroid but not biological therapy elevates the risk of venous thromboembolic events in inflammatory bowel disease: A meta-analysis. Journal of Crohn's and Colitis, 12(4), 489-498. https://doi.org/10.1093/ecco-jcc/jjx162