IDDF2019-ABS-0208 Exciting results with injection darbepoietin alfa and pegfilgrastim in patients with decompensated liver cirrhosis

Abstract

Background Dysregulated erythropoietin (EPO) plasma levels may play a role in the pathophysiology of liver cirrhosis. No report of Darbepoetin alpha and Pegylated Filgrastim use in Liver Cirrhosis. Methods To study the benefits of Darbepoetin and Pegfilgrastim in patients with de-compensated liver cirrhosis. Prospectively clinical data recorded since October 2014. Patients with active bleed, hepatorenal syndrome, hepatoma, portal vessel thrombosis were excluded. Patients started on Injection Darbepoetin alpha 200 microgram and Injection Pegfilgrastim 6 mg subcutaneously every 15days, total of three visits of patients, then three months follow up planned. Improvement in clinical, laboratory parameters analyzed. Median calculated, Wilcoxon Signed-Rank Test applied to compare both groups. Results N=22 all male, 3 lost to follow up, aetiology of cirrhosis were Non-alcoholic Fatty Liver Disease 5, Hepatitis B Virus 3, Hepatitis C Virus 2 and Alcohol 12. Median age 59years (range: 40 to 70). Improvement in Haemoglobin from 10.1 gram% (range 5.9–13.4 gm%) to 10.6 gm% (range: 7.5–13.7 gm%) p value 0.00374, Total leukocyte count from 5100/cu mm to 7100/cu mm p value 0.00214, Platelet count 90,000/cu mm to 146,000/cu mm, p value 0.00096, INR 1.7 (range 1.5–4.8) to 1.4 p value 0.00064, Albumin 2.4 gram/dl (range 1.6–2.9) to 2.5 gm/dl (range 1.8–3.5) P value 0.043, Child score from 10 to 8 P value 0.007, ascites score 2 to 1, P value 0.00222. No significant improvement in Serum creatinine, sodium, potassium, calcium, bilirubin, total protein and hepatic encephalopathy. High cost of medicine was the limiting factor. Conclusions Our study suggests that Darbepoetin Alpha and Pegfilgrastim is significantly effective in improving hematology, International normalized ratio, Albumin, ascites and Child score of liver cirrhosis patients.