炎症性肠病 (IBD) 患者发生静脉血栓栓塞事件 (VTE) 的风险比一般人群高两倍以上。病因复杂，药物作用尚无明确定义。我们旨在评估抗肿瘤坏死因子α（抗TNFα）药物和常规抗炎治疗，即皮质类固醇（CS）、免疫调节剂（IM）的效果）和 5-氨基水杨酸盐​​（5-ASA）对 IBD 中 VTE 的影响。2022 年 11 月 22 日在五个数据库中进行了系统检索。我们将报告 VTE 的研究纳入不同类别的药物中，确定了比例，并计算了使用随机效应模型计算比值比 (OR) 和 95% 置信区间 (CI)。使用 Joanna Briggs Institute 批判性评估清单和干预措施非随机研究中的偏倚风险工具评估偏倚风险。定量分析包括 16 项观察性研究，数据来自 91,322 名 IBD 患者。接受抗 TNFα 药物治疗的患者的 VTE 显着低于接受 CS 治疗的患者（比例：0.05，CI：0.02-0.10）（比例：0.16，CI：0.07-0.32），OR = 0.42（CI：0.25-0.71） 。与生物制剂相比，IM 导致的 VTE 比例相似（0.05，CI：0.03-0.10），OR = 0.94（CI：0.67-1.33）。接受 5-ASA 治疗的患者发生 VTE 的比例为 0.09（CI：0.04-0.20），OR=1.00（CI：0.61-1.62）。在严重发作和多种 VTE 危险因素的情况下，应优先选择生物制剂而不是皮质类固醇，因为它们与这些并发症的发生几率降低有关。需要进一步研究来验证我们的数据。© 作者 2023。由牛津大学出版社代表欧洲克罗恩病和结肠炎组织出版。

Patients with inflammatory bowel disease (IBD) have a more than twofold higher risk of venous thromboembolic events (VTE) than the general population. The etiology is complex, and the role of medication is not precisely defined.We aimed to assess the effect of anti-tumor necrosis factor alpha (anti-TNFα) drugs and conventional anti-inflammatory therapy, namely corticosteroids (CS), immunomodulators (IM), and 5-aminosalicylates (5-ASA) on VTE in IBD.A systematic search was performed in five databases on the 22nd of November 2022. We included studies reporting VTE in the distinct categories of medications, determined the proportions, and calculated the odds ratios (OR) with 95% confidence intervals (CI), using the random-effects model. The risk of bias was evaluated with the Joanna Briggs Institute Critical Appraisal Checklist and the Risk of Bias in Non-randomized Studies of Interventions tool.The quantitative analysis included 16 observational studies, with data from 91,322 IBD patients. Patients receiving anti-TNFα medication had significantly less VTE (proportion: 0.05, CI: 0.02-0.10), than patients treated with CS (proportion: 0.16, CI: 0.07-0.32), with OR=0.42 (CI: 0.25-0.71). IMs resulted in similar proportions of VTE compared with biologics (0.05, CI: 0.03-0.10), with OR=0.94 (CI: 0.67-1.33). The proportion of patients receiving 5-ASA having VTE was 0.09 (CI: 0.04-0.20), with OR=1.00 (CI: 0.61-1.62).Biologics should be preferred over corticosteroids in cases of severe flare-ups and multiple VTE risk factors, as they are associated with reduced odds of these complications. Further studies are needed to validate our data.© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.