Anemia in inflammatory bowel disease and the potential role of erythropoietin (EPO) - A retrospective analysis of the Göttingen patient collective treated with anti-TNF-alpha antibodies -
by Cosima Feldhaus née Römer
English
Anti-tumor necrosis factor (TNF) therapy has improved the medical treatment of inflammatory bowel diseases (IBD), Crohn’s disease (CD), and ulcerative colitis (UC). The TNF-blocker Infliximab® is widely used as a effective therapeutic option for moderate to severe IBD with a good safety profile.
Anemia, a common complication associated with IBD, is frequently underestimated in the management of IBD patients.
This study will mainly focus on factors limiting the compensatory hematogenesis by erythropoietin (EPO) because of a blunting of the erythropoietin-bone marrow axis, caused by insufficient synthesis of EPO, EPO-resistance, or EPO- single nucleotide polymorphisms (EPO-SNPs).
Objectives:
The study was performed to evaluate the therapeutic effect of Infliximab® on anemia in IBD.
Materials and Methods:
The present descriptive study considered biometric, serological, and clinical data of 73 patients suffering from IBD, treated with Infliximab® in the Department of Gastroenterology and Gastrointestinal Oncology, University of Göttingen.
Out of these 73 patients, EPO-SNP data from 45 patients were available.
Results :
Patients (34 female, 39 male) had a mean age of 40,9 ± 12,8 years.
Of these, 61,6% were suffering from CD, and 38,4% from UC. They had a mean hemoglobin value of 13,7 g/dl (men 14,7 g/dl, women 12,7 g/dl).
23% of patients were anemic at least once during the investigation period.
Out of the anemic patients, 60,9% were suffering from UC, 39,1% from CD.
The correlation between hemoglobin values and erythropoietine was strong and negative (r = -0,574; p < 0.01), i.e. the value of EPO increased with a decrease of hemoglobin.
There was also a minor significant negative correlation (r = -0,177, p = < 0.05) between hemoglobin and C-reactive protein values.
Concerning EPO-SNPs 6 of 45 patients had polymorphism GG, 14 TT, 25 GT.
Conclusion:
No significant associations between EPO-resistance and EPO-SNPs with anemia were found.
Discussion:
More studies are warranted to determine the possible influence of EPO-Resistance, and EPO-SNPs on anemia in IBD. Awareness about iron deficiency in IBD is recommended.
Keywords: IBD, anemia, anti-TNF therapy, Crohn’s disease, ulcerative colitis; IBD, anemia, anti-TNF therapy, Crohn’s disease, ulcerative colitis
Persistent Address:
http://dx.doi.org/10.53846/goediss-8460
