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P123. Use of soluble transferrin receptor/log10 ferritin index as a predictor of response to intravenous iron administration in patients with inflammatory bowel disease and anemia

C. Georgousaki1, P. Oustamanolakis1, S. Terzoudis1, E. Kouroumalis1, I. Koutroubakis1, 1University Hospital Heraklion, Gastroenterology, Heraklion, Greece

Background

Intravenous iron is considered to be a safe and effective treatment of anemia in patients with inflammatory bowel disease (IBD). However, there are no reliable predictive indexes of treatment response. Aim of this study was to evaluate the use of soluble transferrin receptor/log10 ferritin index (sTfR-F) as a predictor of the effectiveness of intravenous iron in IBD-associated anemia.

Methods

54 patients with IBD were included in this study (30 men, 22 ulcerative colitis, 32 Crohn's disease). Intravenous ferric carboxymaltose was administered at a maximum dose of 15 mg/kg or 1000 mg within 15 min. Anemia was defined as hemoglobin Hb <13 g/dl in men and Hb <12 g/dl in women. Several laboratory and clinical parameters were analyzed including sTfR-F index at week 0 and week 4.

Results

Ferric carboxymaltose was administered at a mean dose of 1290±329 mg. Hemopoietic response (increase of Hb >2 g/dl) was observed in 66.7% of the patients. Mean CRP and ESR values were not statistically significant different between the two phases of the study and no significant correlation between CRP and sTfR-F index was found. Intravenous ferric carboxymaltose infusion had as a result a significant reduction of sTfR-F index at week 4 compared to week 0 (p < 0.0001). Patients with hemopoietic response after treatment had significantly higher baseline sTfR-F (5.2±3.6) compared to those without response (1.5±0.8). Baseline sTfR-F >1.4 had a sensitivity of 91.8% and specificity of 94.4% in the prediction of the hemopoietic response.

Conclusion

sTfR-F index is a highly reliable predictive index of the effectiveness of intravenous ferric carboxymaltose infusion in IBD-associated anemia.