Pediatric IBD patients have more VTEs than general pediatric populace
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There was a 15-fold increase of venous thromboembolism among the pediatric inflammatory bowel disease population compared with the general population, according to presenter at Digestive Disease Week.
“This highlights the importance of the study where we clearly demonstrated an increased risk and also highlights the importance of updating the guidelines,” Renz Klomberg, MD, from Erasmus Medical Center, Netherlands, said during his presentation. “Therefore, based on our results and other literature we propose alternative recommendations for thromboprophylaxis.
“We now advise to consider [venous thromboembolism (VTE)] prophylaxis for all hospitalized pediatric [ulcerative colitis] patients with anti-saccharomyces cerevisiae regardless of the presence of additional risk factors and regardless of age.”
Between October 2016 and September 2019, Klomberg and colleagues enrolled 149 pediatric gastroenterologists from 131 unique sites in 31 countries to participate in a safety registry study. Participants replied to an electronic survey monthly indicating when they observed 10 predefined complications such as VTE in an IBD patient aged younger than 19 years. Data collected include patient characteristics, IBD details and VTE. Physicians reported annually on the number of pediatric IBD patients under their care, which was used to calculate VTE incidence.
Physicians reported 21 cases of VTE for 53,762 patient-years of follow-up. This resulted in an observed incidence of 3.91 per 10,000 patients annually (95% CI, 2.42-5.97).
Klomberg said this was a 15-fold increase compared with the VTE incidence in the general pediatric population.
The investigators reported there were 20 cases with additional information that included 10 cerebral sinus venous thrombosis, six lower extremity deep vein thrombosis (DVT), one upper extremity DVT, one right atrial thromboembolism and three pulmonary embolisms. Of the children with VTE, 14 had UC/IBD-U with pancolitis.
Risk factors, which were reported among 65% of cases, included steroids (n = 9), immobility (n = 4), presence of a central venous catheter (n = 3), parenteral nutrition (n = 2), sepsis (n = 1) and surgery (n = 2). There were no cases of hereditary or acquired thrombophilia. According to the physician’s global assessment, 15 patients had moderate or severe disease activity.
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Klomberg R, et al. Abstract 730. Presented at: Digestive Disease Week; May 21-24, 2021 (virtual meeting).
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