Credit: Kevin MacKenzie
Corticosteroid use may increase the risk of venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD), according to a study published in Clinical Gastroenterology and Hepatology.
The study showed that IBD patients who received corticosteroids alone or in combination with biologic therapy had a significantly higher risk of developing VTE than patients who received only biologic therapy.
“Venous thromboembolism is common in IBD and can lead to significant morbidity, increased death, and high rates of recurrent blood clots,” said lead study author Peter D.R. Higgins, MD, PhD, of the University of Michigan in Ann Arbor.
“The importance of understanding what causes this complication in this patient group cannot be understated.”
With that in mind, Dr Higgins and his colleagues conducted a retrospective analysis of adults with IBD identified from the Truven Health MarketScan® Databases.
The researchers assessed the rates of VTE over a 12-month period in 15,100 patients who were treated with biologics, corticosteroids, or a combination of the two.
In all, there were 325 VTEs. They occurred in 2.25% of patients who received only corticosteroids, 0.44% of patients who received biologics only, and 2.49% of patients who received combination therapy.
So the unadjusted risk of VTE within 12 months of an index prescription was 5-fold higher in patients who received corticosteroids alone and in combination with biologics than in patients who received biologics alone (P=0.028).
In a multivariate analysis in which corticosteroid-treated patients served as the reference, the odds ratio for VTE was 0.21 in patients who received biologics only (P<0.05) and 1.01 in patients treated with combination therapy (no significant difference).
“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,” Dr Higgins said.
He and his colleagues noted that, although the association between active IBD flares and VTE has been well established, this is the first study to show a strong, independent association between corticosteroid use and VTE.
The study was funded by AbbVie Inc.
