The Influence of Anti-tumor Necrosis Factor Agents on Hemoglobin Levels of Patients with Inflammatory Bowel Disease

Overview

Journal Inflamm Bowel Dis

Publisher Oxford University Press

Specialty Gastroenterology

Date 2015 May 2

PMID 25933393

Citations 17

Authors

Ioannis E Koutroubakis

Claudia Ramos-Rivers

Miguel Regueiro

Efstratios Koutroumpakis

Benjamin Click

Marc Schwartz

Jason Swoger

Leonard Baidoo

Jana G Hashash

Arthur Barrie

Michael A Dunn

David G Binion

Affiliations

Soon will be listed here.

Abstract

Background: Anti-tumor necrosis factor (TNF) agents are an important component of inflammatory bowel disease (IBD) treatment, but data on their influence on anemia, a frequent complication of IBD, are limited. The aim of this study was to evaluate the effect of anti-TNF agents on hemoglobin (Hb) levels in a large IBD cohort.

Methods: Prospectively collected demographic, clinical, laboratory, and treatment data from IBD patients who started anti-TNF treatment at a tertiary referral center during the years 2010 to 2012 were analyzed. Follow-up data including disease activity scores (Harvey-Bradshaw index or ulcerative colitis activity index), quality of life scores (short IBD questionnaire) completed at each visit, and laboratory data were analyzed. Data from the year of anti-TNF initiation (yr 0) to the following year (yr 1) were compared.

Results: A total of 430 IBD patients (324 with Crohn's disease, 51.6% females) started anti-TNF treatment. The prevalence of anemia and median Hb levels did not change between years 0 and 1. Median short IBD questionnaire was significantly improved at year 1 (P = 0.002). IBD patients with anemia had significantly higher median Hb levels at year 1 compared with year 0 (P = 0.0009). Hematopoietic response (increase of Hb ≥2 g/dL) was observed in only 33.6% of the 134 anemic IBD patients, despite iron replacement being administered in 126 anemic patients (oral, 77%). Improvement in Hb levels was independently significantly correlated with change of C-reactive protein levels (P = 0.04) and immunomodulator use (P = 0.03).

Conclusions: Anemia remains a significant manifestation of IBD 1 year after treatment with anti-TNF agents.

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