Anticoagulant therapy for venous thromboembolism in patients with inflammatory bowel disease. Issue 5 (May 2018)

• Record Type: Journal Article
• Authors: Lobo, Jose L.; Garcia-Fuertes, Julia A.; Trujillo-Santos, Javier; Merah, Adel; Blanco-Molina, María Á.; Casado, Ignacio; Hirmerova, Jana; De Miguel, Javier; Salgado, Estuardo; Monreal, Manuel
• Is Part Of: European journal of gastroenterology & hepatology. Volume 30:Issue 5(2018:May)
• Publication Date: 2018-05
• Subjects: anticoagulants -- embolism and thrombosis -- hemorrhage -- inflammatory bowel disease; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000001084
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Background: There is lack of evidence to guide the type, intensity, and the duration of anticoagulation following venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD). Patients and methods: Registro Informatizado Enfermedad Trombo Embólica (RIETE) is an ongoing, multicenter, observational registry of consecutive patients with symptomatic, objectively confirmed, acute VTE. We used the RIETE database to compare the rate of VTE recurrences and major bleeding during the course of anticoagulation in noncancer patients with or without IBD. Results: As of October 2014, 41 927 patients without active cancer have been recruited in RIETE. Of these, 265 (0.63%) had IBD and 85 (32%) had the VTE during an acute flare. The duration of anticoagulation was similar in patients with VTE during an acute flare (8.3±8.8 months), in remission (9.4±11.5 months), or without IBD (10.0±12.8 months). The rate of VTE recurrences [7.25, 95% confidence interval (CI): 1.46–21.2; 8.84, 95% CI: 3.23–19.2; and 5.85, 95% CI: 5.46–6.26 per 100 patient-years, respectively] and major bleeding (7.25, 95% CI: 1.46–21.2; 2.95, 95% CI: 0.33–10.6; and 4.79, 95% CI: 4.44–5.15, respectively) were similar in all three subgroups. Propensity score matching analysis confirmed the absence of differences in the rate of VTE recurrences (rate ratio: 1.16, 95% CI: 0.54–2.47) or major bleeding (rate ratio: 0.84, 95% CI: 0.31–2.23) between patients with or without IBD. Conclusion: Therapeutic anticoagulation for patients with IBD and VTE is as safe and effective as for those with VTE without IBD. Abstract : Supplemental Digital Content is available in the text.