While the presence of inflammatory bowel disease (IBD) increases the risk for a venous thromboembolic event (VTE) in affected patients, thrombophilia does not play a role in the pathway of increased risk, according to study results published in the Journal of Clinical Gastroenterology.
The single-center, case-control study matched 44 patients with IBD, who experienced a VTE (IBD-VTE), with 127 patients without IBD, who experienced a VTE (non-IBD-VTE). Provoking risk factors for VTE were assessed, and each patient underwent comprehensive lab work to screen for thrombophilia.
Thrombophilia rates were comparable between the overall IBD-VTE and non-IBD-VTE groups. When analyzing only unprovoked VTE, however, the IBD-VTE group had significantly lower rates of thrombophilia compared with the non-IBD-VTE group (42.1% and 70.7%, respectively; P =.03). Most IBD-VTE patients without thrombophilia who experienced an unprovoked VTE had active inflammation at the time of the VTE (62.5%).
The study is limited by the small sample size as well as incomplete data regarding cofounders such a VTE prophylaxis. Despite these limitations, the investigators believe that thrombophilia does not play a role in the increased VTE risk in patients with IBD.
“…[B]ased on this case-control analysis, traditional thrombophilia does not appear to add to the risk of VTE in the IBD population over the risk attributed to the inflammation per se,” the study authors noted. “It is possible that this population might have different thrombophilia that are not yet identified. Additional studies to assess the mechanisms of thrombosis in active IBD and better stratify patients at risk are needed.”
Ollech JE, Waizbard A, Lubetsky A, et al. Venous thromboembolism among patients with inflammatory bowel diseases is not related to increased thrombophilia. J Clin Gastroenterol. 2022;56:e222-226. doi:10.1097/MCG.0000000000001578