Abstract
Background
Tumor necrosis factor-α (TNF-α) is involved in inducing inflammatory anemia. The potential
effect of anti–TNF-α agents on anemia in inflammatory bowel diseases (IBD) is still
unknown.
Methods
Analytical data and disease characteristics from 362 IBD patients [271 CD/91UC) treated
with anti-TNF-α drugs were retrospectively collected. Effects on disease activity,
blood markers and prevalence of anemia were assessed after 6 and 12 months of therapy.
Results
29.3% patients presented anemia at baseline, and significantly reduced to 14.4% and
7.8% after 6 and 12 months of therapy, respectively. Mean ± SD Hb levels increased
significantly at month 6, and this increase was sustained at 12 months. Serum markers
of iron metabolism increased significantly compared to baseline, as disease activity
measured by C-reactive protein (CRP) was reduced. All these effects were observed
independently for CD and UC, and were independent of iron supplementation during treatment.
Anemia at baseline (OR 4.09; 95%CI 1.98–8.45) and elevated CRP (OR 3.45; 95CI 1.29–9.22)
were independently associated with risk of persistent anemia, as well as iron replacement
during therapy (OR 4.36; 95%CI 2.07–9.16).
Conclusions
Controlling disease activity with anti-TNF- α therapy significantly and independently
associated with resolution of anemia in IBD, with no relevant role for iron replacement
therapy.
Keywords
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Article info
Publication history
Published online: December 28, 2019
Accepted:
November 22,
2019
Received:
September 11,
2019
Identification
Copyright
© 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
