Supplementary Material for: No increased risk of venous thromboembolism or infectious complications after JAK inhibitor exposure in patients with ulcerative colitis undergoing surgery

Introduction Total colectomy for ulcerative colitis (UC) is associated with postoperative morbidity, including venous thromboembolic events (VTE). In light of recent concerns on increased major adverse events associated with JAK inhibitor exposure, we aimed to evaluate the postoperative VTE risk as well as other complications in UC patients undergoing colectomy. Methods This single-center retrospective cohort study included all UC patients who underwent (procto)colectomy between 2013 and March 2022, and documented the 180-day postoperative non-infectious and infectious complications. Results One hundred seventy-five UC patients (43.4% women, median age 41.0 years) underwent colectomy. Forty-nine patients (28.0%) were operated in an urgent setting. In the twelve weeks prior to surgery, 53 (30.3%) patients had received anti-TNF agents, 40 (22.9%) anti-adhesion therapy, 16 (9.1%) anti-IL12/23 and 34 (19.4%) JAK inhibitors. Preoperatively, 26 patients (14.9%) received moderate to high doses of systemic corticosteroids. All except two patients received prophylactic LMWH postoperatively. During the 180-day postoperative period, 2 patients developed a thrombosis, all incidental findings on abdominal CT scan. No VTE was seen in the patients who underwent colectomy while on JAK inhibitor. Three out of 34 JAK-inhibitor treated patients (8.8%) developed a postoperative infectious complication, while the overall incidence of infectious complications was 17.1%. Conclusion Our findings suggest that the overall VTE risk in UC patients undergoing colectomy is low with adequate antithrombotic prophylaxis. JAK inhibitor use prior to surgery was not linked to increased short-term thromboembolic or infectious complications. However, the limited sample size warrants further study in larger cohorts.引言 溃疡性结肠炎(UC)患者接受全结肠切除术时，术后并发症风险涵盖静脉血栓栓塞事件(VTE)。鉴于近期学界关注JAK抑制剂(JAK inhibitor)暴露与严重不良事件风险升高相关的议题，本研究旨在评估UC患者接受结肠切除术后的VTE风险及其他并发症发生情况。 方法 本项单中心回顾性队列研究纳入2013年至2022年3月期间所有接受（直肠）结肠切除术的UC患者，记录其术后180天内的非感染性与感染性并发症发生情况。 结果 共计175例UC患者接受结肠切除术，其中女性占比43.4%，中位年龄为41.0岁。49例患者（28.0%）接受急诊手术治疗。术前12周内，53例患者（30.3%）接受抗TNF制剂治疗，40例（22.9%）接受抗黏附治疗，16例（9.1%）接受抗IL-12/23治疗，34例（19.4%）接受JAK抑制剂(JAK inhibitor)治疗。术前有26例患者（14.9%）接受中至高剂量全身性糖皮质激素治疗。除2例患者外，其余所有患者术后均接受了预防性低分子量肝素(LMWH)治疗。术后180天随访期间，仅2例患者出现血栓事件，均为腹部CT扫描时的意外发现。在接受JAK抑制剂治疗的患者中未观察到VTE发生。34例接受JAK抑制剂治疗的患者中，3例（8.8%）出现术后感染性并发症，而整体感染性并发症发生率为17.1%。 结论 本研究结果提示，在充分的抗血栓预防措施下，UC患者接受结肠切除术后的整体VTE风险较低。术前使用JAK抑制剂并未与短期血栓栓塞或感染并发症风险升高存在关联。但本研究样本量有限，需在更大规模队列中开展进一步研究以验证上述结论。