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Immune-mediated diseases and thromboembolic events: a modified Delphi panel
Nassir Azimi1, Freddy Caldera2, Stan Cohen3
1Sharp Grossmont Hospital, La Mesa, CA, USA.
Current Medical Research and Opinion
|May 26, 2021
Summary
Physicians identified immune-mediated diseases (IMDs) like ulcerative colitis and Crohn's disease as high risk for thromboembolic events (TEs). Management strategies focus on modifying therapies and patient behaviors to mitigate TE risks.
Area of Science:
- Clinical Medicine
- Rheumatology
- Gastroenterology
Background:
- Thromboembolic events (TEs) are a significant concern in immune-mediated diseases (IMDs).
- Understanding the relationship between specific IMDs and TE risk is crucial for patient management.
- Identifying modifiable and non-modifiable risk factors is essential for preventative strategies.
Purpose of the Study:
- To establish consensus among physicians on IMDs with the highest risk of TEs.
- To identify factors influencing TE risk in patients with IMDs.
- To recommend strategies for mitigating TE incidence in this population.
Main Methods:
- A modified Delphi panel of 13 national experts was convened.
- The panel engaged through semi-structured interviews, questionnaires, in-person discussions, and consensus surveys.
- Physicians' expertise was based on contributions to guidelines, publications, and patient care.
Main Results:
- Ulcerative colitis and Crohn's disease were identified among the top four IMDs with the highest TE risk.
- Consensus was reached on non-modifiable and modifiable risk factors for TEs.
- Therapeutic approaches, including monitoring and behavioral modifications, were identified to reduce TE incidence. Janus kinase inhibitors and corticosteroids require further evaluation for TE risk.
Conclusions:
- Several IMDs are associated with an elevated risk of TEs.
- Physicians can influence TE risk by carefully selecting therapies, considering patient-specific IMDs and risk factors.
- Optimizing management and reducing TE risk requires a comprehensive approach to therapy selection and patient monitoring.
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