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Corticosteroids increased risk for venous thromboembolic events in IBD patients
Compared with biologic monotherapy, corticosteroid monotherapy and combination therapy with corticosteroids plus biologics were associated with a fivefold increase in risk for venous thromboembolic events in patients with inflammatory bowel disease, according to new research data.
“We found that corticosteroid use — either alone or in combination with biologics — substantially increases the rate of venous thromboembolic events,” Peter D. R. Higgins, MD, PhD, MSc, from the University of Michigan, Ann Arbor, said in a press release. “This was strikingly different from the patients who were on biologics alone, who had a significantly lower rate of events. Venous thromboembolism is common in IBD, and can lead to significant morbidity, increased death and high rates of recurrent blood clots. The importance of understanding what causes this complication in this patient group cannot be understated.”
Aiming to determine whether corticosteroids independently contribute to risk for venous thromboembolism in IBD patients with flaring disease, Higgins and colleagues retrospectively analyzed data on 15,100 adults with IBD identified using the Truven Health MarketScan databases. Included patients were prescribed a steroid and/or biologic from 2003 to 2009, had continuous medical coverage 6 months before and 12 months after first diagnosis, and did not have venous thromboembolism in the preceding 6-month period.
Venous thromboembolism occurred in 335 patients within 1 year of therapy, in 2.25% of patients receiving corticosteroid monotherapy, 0.44% receiving biologic monotherapy and 2.49% receiving corticosteroid plus biologic combination therapy. Patients receiving corticosteroids alone or in combination with biologics had a fivefold increased risk for venous thromboembolism compared with patients who received biologic monotherapy (P=.028). The adjusted OR for venous thromboembolism in patients with biologic monotherapy was 0.21 (95% CI, 0.05-0.87) compared with corticosteroid monotherapy; for combination therapy, adjusted OR was 1.01.
“Combination therapy with corticosteroids and biologics was associated with nearly the same risk as corticosteroids alone, validating our conclusion that corticosteroids may truly increase venous thromboembolism risk, and eliminate the potential benefit (for venous thromboembolic events) of inducing remission with biologics alone,” Higgins said.
Disclosure: Higgins and the other researchers report various financial ties with AbbVie.