Recombinant human erythropoietin in patients with inflammatory bowel disease and refractory anemia: A 15-year single center experience

摘要

Aim of the study: To describe our 15-year experience on the patients' response and safety to the use of EPO in IBD patients with refractory anemia. Patients-Methods: Single center retrospective chart analysis of all IBD patients receiving EPO for the period 1994-2009. Patients with resistant anemia not responding to I.V. iron therapy were enrolled. Concommitant medication, medical and laboratory data on short and long-term patients' responses and safety were recorded. Results: In total 820 IBD files were reviewed and among 78 patients treated with I.V. iron we identified 26 patients who received EPO in concordance to our inclusion criteria. Azathioprine or methotrexate was administered in 17 patients and 7 patients received concomitant Infliximab. After EPO, 22/26 patients (84.6%) responded and peripheral blood parameters were significantly improved and blood transfusions were significantly decreased (p < 0.001). Erythropoietin dose was increased in three non-responders while two patients required emergency transfusions. No adverse events were recorded. Conclusions: In anemic IBD patients who are refractory to I.V. iron monotherapy, administration of EPO significantly improved peripheral blood parameters with safety. Prospective controlled trials are needed to confirm positive patients' response to EPO and identify those patients who are more likely to benefit.