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.
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 IBDpatients, despite iron replacement being administered in 126 anemicpatients (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.
Authors: Mark S Silverberg; Jack Satsangi; Tariq Ahmad; Ian D R Arnott; Charles N Bernstein; Steven R Brant; Renzo Caprilli; Jean-Frédéric Colombel; Christoph Gasche; Karel Geboes; Derek P Jewell; Amir Karban; Edward V Loftus; A Salvador Peña; Robert H Riddell; David B Sachar; Stefan Schreiber; A Hillary Steinhart; Stephan R Targan; Severine Vermeire; B F Warren Journal: Can J Gastroenterol Date: 2005-09 Impact factor: 3.522
Authors: Jean Frédéric Colombel; William J Sandborn; Walter Reinisch; Gerassimos J Mantzaris; Asher Kornbluth; Daniel Rachmilewitz; Simon Lichtiger; Geert D'Haens; Robert H Diamond; Delma L Broussard; Kezhen L Tang; C Janneke van der Woude; Paul Rutgeerts Journal: N Engl J Med Date: 2010-04-15 Impact factor: 91.245
Authors: Helen A Papadaki; Heraklis D Kritikos; Vasilis Valatas; Dimitrios T Boumpas; George D Eliopoulos Journal: Blood Date: 2002-07-15 Impact factor: 22.113
Authors: Maria H Lönnkvist; Ragnar Befrits; Jon O Lundberg; Joachim Lundahl; Ulrika L Fagerberg; Henrik Hjortswang; Marianne van Hage; Per M Hellström Journal: Eur J Gastroenterol Hepatol Date: 2009-10 Impact factor: 2.566
Authors: Remo Panaccione; Subrata Ghosh; Stephen Middleton; Juan R Márquez; Boyd B Scott; Laurence Flint; Hubert J F van Hoogstraten; Annie C Chen; Hanzhe Zheng; Silvio Danese; Paul Rutgeerts Journal: Gastroenterology Date: 2014-02 Impact factor: 22.682
Authors: Efstratios Koutroumpakis; Claudia Ramos-Rivers; Miguel Regueiro; Jana G Hashash; Arthur Barrie; Jason Swoger; Leonard Baidoo; Marc Schwartz; Michael A Dunn; Ioannis E Koutroubakis; David G Binion Journal: Dig Dis Sci Date: 2015-10-29 Impact factor: 3.199
Authors: Ioannis E Koutroubakis; Claudia Ramos-Rivers; Miguel Regueiro; Efstratios Koutroumpakis; Benjamin Click; Robert E Schoen; Jana G Hashash; Marc Schwartz; Jason Swoger; Leonard Baidoo; Arthur Barrie; Michael A Dunn; David G Binion Journal: Clin Gastroenterol Hepatol Date: 2015-04-08 Impact factor: 11.382
Authors: Meredith A Atkinson; Mary B Leonard; Rita Herskovitz; Robert N Baldassano; Michelle R Denburg Journal: J Pediatr Gastroenterol Nutr Date: 2018-01 Impact factor: 2.839
Authors: Jong Lyul Lee; Chang Sik Yu; Seok-Byung Lim; In Ja Park; Yong Sik Yoon; Chan Wook Kim; Suk-Kyun Yang; Jin Cheon Kim Journal: Medicine (Baltimore) Date: 2016-05 Impact factor: 1.889
Authors: Iain C Macdougall; Josep Comin-Colet; Christian Breymann; Donat R Spahn; Ioannis E Koutroubakis Journal: Adv Ther Date: 2020-04-15 Impact factor: 3.845