Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian association of gastroenterology

Geoffrey C. Nguyen, Charles N. Bernstein, Alain Bitton, Anthony K. Chan, Anne M. Griffiths, Grigorios I. Leontiadis, William Geerts, Brian Bressler, J. Decker Butzner, Marc Carrier, Nilesh Chande, John K. Marshall, Chadwick Williams, Clive Kearon

Research output: Contribution to journalArticlepeer-review

177 Scopus citations

Abstract

Background & Aims Guidelines for the management of venous thromboembolism (VTE) from the American College of Chest Physicians do not address patients with inflammatory bowel disease (IBD), a group with a high risk of both VTE and gastrointestinal bleeding. We present recommendations for the prevention and treatment of VTE in patients with IBD. Methods A systematic literature search was performed to identify studies on VTE in IBD. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach. Statements were developed through an iterative online platform, then finalized and voted on by a working group of adult and pediatric gastroenterologists and thrombosis specialists. Results IBD patients have an approximately 3-fold higher risk of VTE compared with individuals without IBD, and disease flares further increase this risk. Anticoagulant thromboprophylaxis is recommended for IBD patients who are hospitalized with IBD flares without active bleeding and is suggested when bleeding is nonsevere. Anticoagulant thromboprophylaxis is suggested during moderate-severe IBD flares in outpatients with a history of VTE provoked by an IBD flare or an unprovoked VTE, but not otherwise. The recommended duration of anticoagulation after a first VTE is based on the presence of provoking factors. Specific suggestions are made for the prevention and treatment of VTE in pediatric and pregnant IBD patients. Conclusions Using the American College of Chest Physicians' guidelines as a foundation, we have integrated evidence from IBD studies to develop specific recommendations for the management of VTE in this high-risk population.

Original languageEnglish (US)
Pages (from-to)835-848.e6
JournalGastroenterology
Volume146
Issue number3
DOIs
StatePublished - Mar 2014
Externally publishedYes

Keywords

  • Anticoagulant Therapy
  • Crohn's Disease
  • Inflammatory Bowel Disease
  • Ulcerative Colitis
  • Venous Thromboembolism

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Fingerprint

Dive into the research topics of 'Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian association of gastroenterology'. Together they form a unique fingerprint.

Cite this