TY - JOUR
T1 - The Incidence and Characteristics of Venous Thromboembolisms in Paediatric-Onset Inflammatory Bowel Disease
T2 - A Prospective International Cohort Study Based on the PIBD-SETQuality Safety Registry
AU - Aardoom, Martine A.
AU - Klomberg, Renz C.W.
AU - Kemos, Polychronis
AU - Ruemmele, Frank M.
AU - Fagbemi, Andrew
AU - Kiparissi, Fevronia
AU - Schweizer, Joachim J.
AU - Sebastian, Shaji
AU - Russell, Richard K.
AU - Torrente, Franco
AU - Van Mill, Marije
AU - De Ridder, Lissy
AU - Croft, Nicholas M.
AU - Tempia-Caliera, Michela
AU - Lee, Way Seah
AU - Pigott, Anna J.
AU - Classen, Martin
AU - Morris, Mary Anne
AU - Muhammed, Rafeeq
AU - Hussey, Seamus
AU - Cananzi, Mara
AU - Menz, Timothy J.
AU - Wahbeh, Ghassan T.
AU - Van Ommen, C. H.Heleen
AU - De Ridder, Lissy
AU - Croft, Nicholas M.
AU - Turner, Dan
AU - Focht, Gili
AU - Croft, Nicholas
AU - De Ridder, Lissy
AU - Samsom, Janneke
AU - Veereman, Gigi
AU - Neyt, Mattias
AU - Kemos, Polychronis
AU - Koletzko, Sibylle
AU - Brückner, Annecarin
AU - Levine, Arie
AU - Russell, Richard
AU - Levine, Arie
AU - Weiner, Dror
AU - Griffiths, Anne
AU - Aloi, Marina
AU - Raes, Jeroen
AU - Christiaens, Annick
AU - Walters, Thomas
AU - Walker, Michael
AU - Ruemelle, Frank
AU - Demange, Christine Nguyen
AU - Bigot, Laetitia
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn's and Colitis Organisation.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background and Aims: Guidelines regarding thromboprophylaxis for venous thromboembolisms [VTEs] in children with inflammatory bowel disease [IBD] are based on limited paediatric evidence. We aimed to prospectively assess the incidence of VTEs in paediatric-onset IBD [PIBD], characterize PIBD patients with a VTE and identify potential IBD-related risk factors. Methods: From October 2016 to September 2020, paediatric gastroenterologists prospectively replied to the international Safety Registry, monthly indicating whether they had observed a VTE case in a patient <19 years with IBD. IBD details [type, Paris classification, clinical and biochemical disease activity, treatment] and VTE details [type, location, treatment, outcome] were collected. To estimate VTE incidence, participants annually reported the number of PIBD patients, data source and catchment area of their centre. A systematic literature review and meta-analysis was performed to calculate the VTE incidence in the general paediatric population. Results: Participation of 129 PIBD centres resulted in coverage of 24 802 PIBD patients. Twenty cases of VTE were identified [30% Crohn's disease]. The incidence of VTEs was 3.72 (95% confidence interval [CI] 2.27-5.74) per 10 000 person-years, 14-fold higher than in the general paediatric population (0.27 [95% CI 0.18-0.38], p < 0.001). Cerebral sinus venous thrombosis was most frequently reported [50%]. All but one patient had active IBD, 45% were using steroids and 45% were hospitalized. No patient received thromboprophylaxis, whereas according to current PIBD guidelines, this was recommended in 4/20 patients. Conclusion: There is an increased risk of VTEs in the PIBD population compared to the general paediatric population. Awareness of VTE occurrence and prevention should be extended to all PIBD patients with active disease, especially those hospitalized.
AB - Background and Aims: Guidelines regarding thromboprophylaxis for venous thromboembolisms [VTEs] in children with inflammatory bowel disease [IBD] are based on limited paediatric evidence. We aimed to prospectively assess the incidence of VTEs in paediatric-onset IBD [PIBD], characterize PIBD patients with a VTE and identify potential IBD-related risk factors. Methods: From October 2016 to September 2020, paediatric gastroenterologists prospectively replied to the international Safety Registry, monthly indicating whether they had observed a VTE case in a patient <19 years with IBD. IBD details [type, Paris classification, clinical and biochemical disease activity, treatment] and VTE details [type, location, treatment, outcome] were collected. To estimate VTE incidence, participants annually reported the number of PIBD patients, data source and catchment area of their centre. A systematic literature review and meta-analysis was performed to calculate the VTE incidence in the general paediatric population. Results: Participation of 129 PIBD centres resulted in coverage of 24 802 PIBD patients. Twenty cases of VTE were identified [30% Crohn's disease]. The incidence of VTEs was 3.72 (95% confidence interval [CI] 2.27-5.74) per 10 000 person-years, 14-fold higher than in the general paediatric population (0.27 [95% CI 0.18-0.38], p < 0.001). Cerebral sinus venous thrombosis was most frequently reported [50%]. All but one patient had active IBD, 45% were using steroids and 45% were hospitalized. No patient received thromboprophylaxis, whereas according to current PIBD guidelines, this was recommended in 4/20 patients. Conclusion: There is an increased risk of VTEs in the PIBD population compared to the general paediatric population. Awareness of VTE occurrence and prevention should be extended to all PIBD patients with active disease, especially those hospitalized.
KW - Crohn's disease
KW - complication
KW - extra-intestinal manifestation
KW - paediatric
KW - ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=85133101207&partnerID=8YFLogxK
U2 - 10.1093/ecco-jcc/jjab171
DO - 10.1093/ecco-jcc/jjab171
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C2 - 34599822
AN - SCOPUS:85133101207
SN - 1873-9946
VL - 16
SP - 695
EP - 707
JO - Journal of Crohn's and Colitis
JF - Journal of Crohn's and Colitis
IS - 5
ER -