CLINICAL SIGNIFICANCE OF C-REACTIVE PROTEIN LEVELS IN PREDICTING RESPONSIVENESS TO IRON THERAPY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND IRON DEFICIENCY ANEMIA
Abstract
CLINICAL SIGNIFICANCE OF C-REACTIVE PROTEIN LEVELS IN PREDICTING RESPONSIVENESS TO IRON THERAPY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND IRON DEFICIENCY ANEMIA (Abstract): Iron deficiency anemia (IDA) has been recognized as a major cause of anemia in inflammatory bowel disease (IBD). Anemia has a significant impact on the quality of life of these patients and thus correction is very important. Aim: To determine if systemic inflammation (assessed by C-reactive protein [CRP]) can predict the response to iron therapy (oral versus intravenous). Material and methods: A seven-month prospective study (June-December 2016) conducted at the Iasi Institute of Gastroenterology and Hepatology. Sixty-three patients with IBD and IDA were assessed. Inflammation was defined as CRP levels > 4mg/L. Patients were divided as follows: 29 patients received iron based oral treatment (group A) and 34 intravenous therapy [IV] (group B). Results: Of the 29 group A patients 14 responded (11 had CRP levels < 4mg/L and 3 CRP levels > 4mg/L) and 15 did not respond (3 with CRP levels < 4mg/L and 12 with CRP levels > 4mg/L). As to the 35 group B patients, 25 responded (12 with CRP levels < 4mg/L and 13 with CRP levels > 4mg/L) and 9 did not respond (4 with CRP levels < 4mg/L and 5 with CRP levels > 4mg/L). Among iron tablet-treated patients, hemoglobin (Hb) increase was significantly slower in the high versus low CRP subgroup (2.8 vs 3.8 g/dL, p=0.04). Response to IV therapy was independent of inflammation. Conclusions: Patients with higher CRP levels achieved a lower Hb response with oral iron therapy. CRP may be useful in selecting the iron administration route as well as identifying IBD patients who can benefit from first-line IV iron therapy to improve their IDA.
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