In:
Journal of Clinical Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. 9 ( 2020-10), p. 819-825
Abstract:
Active inflammatory bowel diseases (IBD) represent an independent risk factor for venous thromboembolism. The authors investigated the hemostatic profile of IBD patients before and after induction treatment with infliximab, vedolizumab, and methylprednisolone. Study: This prospective study included 62 patients with active IBD starting infliximab, vedolizumab, and/or methylprednisolone, and 22 healthy controls (HC). Plasma was collected before (w0) and after induction therapy (w14). Using a clot lysis assay, amplitude (marker for clot intensity), time to peak ( T max ; marker for clot formation rate), area under the curve (AUC; global marker for coagulation/fibrinolysis), and 50% clot lysis time (50%CLT; marker for fibrinolytic capacity) were determined. Plasminogen activator inhibitor-1 (PAI-1) and fibronectin were measured by ELISA. Clinical remission was evaluated at w14. Results: At baseline, AUC, amplitude, and 50%CLT were significantly higher in IBD patients as compared with HC. In 34 remitters, AUC [165 (103-229)% vs. 97 (78-147)%, P =0.001], amplitude [119 (99-163)% vs. 95 (82-117)%, P =0.002], and 50%CLT [122 (94-146)% vs. 100 (87-129)%, P =0.001] decreased significantly and even normalized to the HC level. Vedolizumab trough concentration correlated inversely to fibronectin concentration ( r , −0.732; P =0.002). The increase in T max for infliximab-treated remitters was significantly different from the decrease in T max for vedolizumab-treated remitters ( P =0.028). The 50%CLT increased ( P =0.038) when remitters were concomitantly treated with methylprednisolone. Conclusions: Control of inflammation using infliximab most strongly reduced those parameters that are associated with a higher risk of venous thromboembolism.
Type of Medium:
Online Resource
ISSN:
0192-0790
DOI:
10.1097/MCG.0000000000001290
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2041558-8
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