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P220. Recombinant human erythropoietin in patients with inflammatory bowel disease and refractory anaemia: A 15-year single centre experience

K.H. Katsanos1, A. Tatsioni2, D.E. Sigounas1, P. Manousou1, D. Chatzidis1, D. Natsi1, K. Kyrili1, I. Vagias1, P. Fouka1, D.K. Christodoulou1, E.V. Tsianos1

1Medical School of Ioannina, University of Ioannina, 1st Division of Internal Medicine and Hepato-Gastroenterology Unit, Ioannina, Greece; 2Tufts University School of Medicine and Institute for Clinical Research and Health Policy Studies, Department of Medicine, Boston, United States

Background: Recombinant human erythropoietin (EPO) has been suggested of value in patients with inflammatory bowel disease (IBD) and refractory anaemia.

Methods: We report herein our 15-year experience on the efficacy and safety of EPO in patients with IBD and refractory anaemia. This was a single-centre retrospective chart analysis of all IBD patients receiving EPO for the period 1994–2009. Patients with resistant anaemia not responding to I.V. iron therapy were enrolled. Concomitant medications, medical and laboratory data on short and long-term efficacy 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). No differences in short or long term clinical or laboratory efficacy parameters were found regarding sex, age, disease type and concomitant therapy. Erythropoietin dose was modified in three non-responders while two patients required emergency transfusions. No adverse events were recorded.

Conclusions: In anaemic IBD patients who are refractory to I.V iron monotherapy, administration of EPO is a safe and efficacious option. EPO significantly improves peripheral blood parameters and decreases blood transfusion requirements. Further studies are needed to identify predictors in patients who are more likely to benefit.