Corticosteroids Increases Blood Clot Risk in IBD Patients

Strong association found between corticosteroids and risk of venous thromboembolism.

Corticosteroid treatment for inflammatory bowel disease (IBD) was associated with a 5-fold increase in venous thromboembolism (VTE) risk compared to biologic therapy, new research suggests.

The study, which appeared in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association, was funded by AbbVie, Inc.

“We found that corticosteroid use—either alone or in combination with biologics—substantially increases the rate of venous thromboembolism events,” Peter D.R. Higgins, MD, PhD, MSc, of 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.”

The retrospective analysis utilized data from the Truven Health MarketScan Databases to monitor 15,100 IBD patients for VTE over a 12-month period.

Patients received biologics, corticosteroids, or combination therapy.

During the study period, a total of 325 VTE events occurred. The rates of VTE among each treatment group were 2.25% for corticosteroid only, 0.44% for biologic only, and 2.49% for combination therapies.

“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 eliminated the potential benefit of inducing remission with biologics alone,” Dr. Higgins said.

The association between IBD flares and VTE has been previously established, and the results indicate a strong association between corticosteroids and VTE. The results may point to different therapeutic approaches for treating severe, IBD-related inflammation.