Korean J Gastroenterol.  2015 Mar;65(3):151-158. 10.4166/kjg.2015.65.3.151.

Prevention and Treatment of Thromboembolism in Patients with Inflammatory Bowel Disease

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. jaejpark@yuhs.ac

Abstract

Although inflammatory bowel disease (IBD) is a chronic disorder that mainly affects the gastrointestinal tract, extraintestinal complications can occur in IBD patients. Among many extraintestinal complications, venous thromboembolism (VTE) is particularly a feared complication due to its significant morbidity and mortality. IBD patients have about 2 to 3 fold higher risk of developing VTE compared with the general population, and the current management guidelines for IBD patients propose recommendations for the prevention of VTE. This review aims to summarize clinical characteristics of VTE in IBD patients and to outline strategies for preventing and treating VTE in these patients.

Keyword

Inflammatory bowel disease; Venous thromboembolism; Prevention; Treatment; Anticoagulation

MeSH Terms

Anticoagulants/*therapeutic use
Heparin, Low-Molecular-Weight/therapeutic use
Humans
Inflammatory Bowel Diseases/complications/*diagnosis
Platelet Aggregation Inhibitors/therapeutic use
Risk Factors
Venous Thromboembolism/*drug therapy/etiology/prevention & control
Anticoagulants
Heparin, Low-Molecular-Weight
Platelet Aggregation Inhibitors

Reference

References

1. Ott C, Schölmerich J. Extraintestinal manifestations and complications in IBD. Nat Rev Gastroenterol Hepatol. 2013; 10:585–595.
Article
2. Patil SA, Cross RK. Update in the management of extraintestinal manifestations of inflammatory bowel disease. Curr Gastroenterol Rep. 2013; 15:314.
Article
3. Yoo YW, Jung SH, Lee YJ, et al. A case of pyoderma gangrenosum associated with ulcerative colitis. Intest Res. 2008; 6:80–84.
4. Choi EJ, Jang BI, Chang KA, et al. A case of hemorrhagic cerebral infarction in ulcerative colitis. Intest Res. 2009; 7:52–55.
5. Kim DH, Paik KH, Shim HJ, et al. Necrotizing myositis as an extraintestinal manifestation of Crohn's disease. Intest Res. 2013; 11:303–305.
Article
6. Fumery M, Xiaocang C, Dauchet L, Gower-Rousseau C, Peyrin-Biroulet L, Colombel JF. Thromboembolic events and cardiovascular mortality in inflammatory bowel diseases: a meta-analysis of observational studies. J Crohns Colitis. 2014; 8:469–479.
Article
7. Singh S, Singh H, Loftus EV Jr, Pardi DS. Risk of cerebrovascular accidents and ischemic heart disease in patients with inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014; 12:382–393.e1.
Article
8. Yuhara H, Steinmaus C, Corley D, et al. Meta-analysis: the risk of venous thromboembolism in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2013; 37:953–962.
Article
9. Bernstein CN, Blanchard JF, Houston DS, Wajda A. The incidence of deep venous thrombosis and pulmonary embolism among patients with inflammatory bowel disease: a population-based cohort study. Thromb Haemost. 2001; 85:430–434.
Article
10. Kappelman MD, Horvath-Puho E, Sandler RS, et al. Thromboembolic risk among Danish children and adults with inflammatory bowel diseases: a population-based nationwide study. Gut. 2011; 60:937–943.
Article
11. Grainge MJ, West J, Card TR. Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study. Lancet. 2010; 375:657–663.
Article
12. Miehsler W, Reinisch W, Valic E, et al. Is inflammatory bowel disease an independent and disease specific risk factor for thromboembolism? Gut. 2004; 53:542–548.
Article
13. Murthy SK, Nguyen GC. Venous thromboembolism in inflammatory bowel disease: an epidemiological review. Am J Gastroenterol. 2011; 106:713–718.
Article
14. Nguyen GC, Bernstein CN, Bitton A, et al. Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology. Gastroenterology. 2014; 146:835–848.e6.
Article
15. Solem CA, Loftus EV, Tremaine WJ, Sandborn WJ. Venous thromboembolism in inflammatory bowel disease. Am J Gastroenterol. 2004; 99:97–101.
Article
16. Nguyen GC, Sam J. Rising prevalence of venous thromboembolism and its impact on mortality among hospitalized inflammatory bowel disease patients. Am J Gastroenterol. 2008; 103:2272–2280.
Article
17. Talbot RW, Heppell J, Dozois RR, Beart RW Jr. Vascular complications of inflammatory bowel disease. Mayo Clin Proc. 1986; 61:140–145.
Article
18. Nguyen GC, Boudreau H, Harris ML, Maxwell CV. Outcomes of obstetric hospitalizations among women with inflammatory bowel disease in the United States. Clin Gastroenterol Hepatol. 2009; 7:329–334.
Article
19. Johns DR. Cerebrovascular complications of inflammatory bowel disease. Am J Gastroenterol. 1991; 86:367–370.
20. Landman C, Nahon S, Cosnes J, et al. Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif. Portomesenteric vein thrombosis in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013; 19:582–589.
Article
21. Schneiderman JH, Sharpe JA, Sutton DM. Cerebral and retinal vascular complications of inflammatory bowel disease. Ann Neurol. 1979; 5:331–337.
Article
22. Hatoum OA, Spinelli KS, Abu-Hajir M, et al. Mesenteric venous thrombosis in inflammatory bowel disease. J Clin Gastroenterol. 2005; 39:27–31.
Article
23. Papay P, Miehsler W, Tilg H, et al. Clinical presentation of venous thromboembolism in inflammatory bowel disease. J Crohns Colitis. 2013; 7:723–729.
Article
24. Papa A, Scaldaferri F, Danese S, et al. Vascular involvement in inflammatory bowel disease: pathogenesis and clinical aspects. Dig Dis. 2008; 26:149–155.
Article
25. Danese S, Papa A, Saibeni S, Repici A, Malesci A, Vecchi M. Inflammation and coagulation in inflammatory bowel disease: the clot thickens. Am J Gastroenterol. 2007; 102:174–186.
Article
26. Papa A, Danese S, Grillo A, Gasbarrini G, Gasbarrini A. Review article: inherited thrombophilia in inflammatory bowel disease. Am J Gastroenterol. 2003; 98:1247–1251.
Article
27. Papa A, Papa V, Marzo M, et al. Prevention and treatment of venous thromboembolism in patients with IBD: a trail still climbing. Inflamm Bowel Dis. 2015. doi: 10.1097/MIB.0000000000000310. [Epub ahead of print].
28. Esmon CT. The interactions between inflammation and coagulation. Br J Haematol. 2005; 131:417–430.
Article
29. Levi M, van der Poll T, Büller HR. Bidirectional relation between inflammation and coagulation. Circulation. 2004; 109:2698–2704.
Article
30. Carty E, MacEy M, Rampton DS. Inhibition of platelet activation by 5-aminosalicylic acid in inflammatory bowel disease. Aliment Pharmacol Ther. 2000; 14:1169–1179.
Article
31. Thomas G, Skrinska VA, Lucas FV. The influence of glutathione and other thiols on human platelet aggregation. Thromb Res. 1986; 44:859–866.
Article
32. Hommes DW, van Dullemen HM, Levi M, et al. Beneficial effect of treatment with a monoclonal anti-tumor necrosis factor-alpha antibody on markers of coagulation and fibrinolysis in patients with active Crohn's disease. Haemostasis. 1997; 27:269–277.
33. Danese S, Sans M, Scaldaferri F, et al. TNF-alpha blockade down-regulates the CD40/CD40L pathway in the mucosal mi-crocirculation: a novel anti-inflammatory mechanism of infliximab in Crohn's disease. J Immunol. 2006; 176:2617–2624.
34. Dentali F, Douketis JD, Gianni M, Lim W, Crowther MA. Meta-analysis: anticoagulant prophylaxis to prevent symptomatic venous thromboembolism in hospitalized medical patients. Ann Intern Med. 2007; 146:278–288.
Article
35. Leizorovicz A, Cohen AT, Turpie AG, Olsson CG, Vaitkus PT, Goldhaber SZ. PREVENT Medical Thromboprophylaxis Study Group. Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients. Circulation. 2004; 110:874–879.
Article
36. Scarpa M, Pilon F, Pengo V, et al. Deep venous thrombosis after surgery for inflammatory bowel disease: is standard dose low molecular weight heparin prophylaxis enough? World J Surg. 2010; 34:1629–1636.
Article
37. O'Connor OJ, Cahill RA, Kirwan WO, Redmond HP. The incidence of postoperative venous thrombosis among patients with ulcerative colitis. Ir J Med Sci. 2005; 174:20–22.
38. Ananthakrishnan AN, Cagan A, Gainer VS, et al. Thromboprophylaxis is associated with reduced post-hospitalization venous thromboembolic events in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2014; 12:1905–1910.
Article
39. Zitomersky NL, Verhave M, Trenor CC 3rd. Thrombosis and inflammatory bowel disease: a call for improved awareness and prevention. Inflamm Bowel Dis. 2011; 17:458–470.
Article
40. Kahn SR, Lim W, Dunn AS, et al. American College of Chest Physicians. Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2 Suppl):e195S–e226S.
41. Van Assche G, Dignass A, Reinisch W, et al. European Crohn's and Colitis Organisation (ECCO). The second European evi-dence-based Consensus on the diagnosis and management of Crohn's disease: special situations. J Crohns Colitis. 2010; 4:63–101.
42. Van Assche G, Dignass A, Bokemeyer B, et al. European Crohn's and Colitis Organisation. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 3: special situations. J Crohns Colitis. 2013; 7:1–33.
Article
43. Kornbluth A, Sachar DB. Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010; 105:501–523.
Article
44. Mowat C, Cole A, Windsor A, et al. IBD Section of the British Society of Gastroenterology. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011; 60:571–607.
Article
45. Ra G, Thanabalan R, Ratneswaran S, Nguyen GC. Predictors and safety of venous thromboembolism prophylaxis among hospitalized inflammatory bowel disease patients. J Crohns Colitis. 2013; 7:e479–e485.
Article
46. Tinsley A, Naymagon S, Enomoto LM, Hollenbeak CS, Sands BE, Ullman TA. Rates of pharmacologic venous thromboembolism prophylaxis in hospitalized patients with active ulcerative colitis: results from a tertiary care center. J Crohns Colitis. 2013; 7:e635–e640.
Article
47. Sam JJ, Bernstein CN, Razik R, Thanabalan R, Nguyen GC. Physicians' perceptions of risks and practices in venous thromboembolism prophylaxis in inflammatory bowel disease. Dig Dis Sci. 2013; 58:46–52.
Article
48. Tinsley A, Naymagon S, Trindade AJ, Sachar DB, Sands BE, Ullman TA. A survey of current practice of venous thromboembolism prophylaxis in hospitalized inflammatory bowel disease patients in the United States. J Clin Gastroenterol. 2013; 47:e1–e6.
Article
49. Shen J, Ran ZH, Tong JL, Xiao SD. Meta-analysis: the utility and safety of heparin in the treatment of active ulcerative colitis. Aliment Pharmacol Ther. 2007; 26:653–663.
Article
50. Panés J, Esteve M, Cabré E, et al. Comparison of heparin and steroids in the treatment of moderate and severe ulcerative colitis. Gastroenterology. 2000; 119:903–908.
Article
51. Novacek G, Weltermann A, Sobala A, et al. Inflammatory bowel disease is a risk factor for recurrent venous thromboembolism. Gastroenterology. 2010; 139:779–787.e1.
Article
52. Nguyen GC, Bernstein CN. Duration of anticoagulation for the management of venous thromboembolism in inflammatory bowel disease: a decision analysis. Am J Gastroenterol. 2013; 108:1486–1495.
Article
53. Tabibian JH, Streiff MB. Inflammatory bowel disease-associated thromboembolism: a systematic review of outcomes with anticoagulation versus catheter-directed thrombolysis. Inflamm Bowel Dis. 2012; 18:161–171.
Article
54. Lopez PR, Stewart DW, Smalligan RD. Recurrent deep vein thrombosis despite warfarin therapy in a patient with Crohn's disease. Postgrad Med. 2010; 122:181–184.
Article
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