Anemia and Iron Deficiency in Outpatients with Inflammatory Bowel Disease: Ubiquitous Yet Suboptimally Managed

Roberta Loveikyte, Menno Boer, on behalf of the Dutch Initiative on Crohn and Colitis (ICC), Catharina N. van der Meulen, Rinze W.F. ter Steege, Greetje Tack, Johan Kuyvenhoven, Bindia Jharap, My K. Vu, Lauran Vogelaar, Rachel L. West, Sander van der Marel, Tessa E.H. Römkens, Zlatan Mujagic, Frank Hoentjen, Adriaan A. van Bodegraven, Fiona D.M. van Schaik, Annemarie C. de Vries, Andrea E. van der Meulen-de Jong*

*Corresponding author for this work

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Abstract

Background: Iron deficiency (ID) and anemia in patients with Inflammatory Bowel Disease (IBD) are associated with a reduced quality of life. We assessed the prevalence of ID and anemia in Dutch outpatients with IBD and compared routine ID(A) management among medical professionals to the European Crohn’s and Colitis Organisation (ECCO) treatment guidelines. Methods: Between January and November 2021, consecutive adult outpatients with IBD were included in this study across 16 Dutch hospitals. Clinical and biochemical data were extracted from medical records. Additionally, medical professionals filled out questionnaires regarding routine ID(A) management. Results: In total, 2197 patients (1271 Crohn’s Disease, 849 Ulcerative Colitis, and 77 IBD-unclassified) were included. Iron parameters were available in 59.3% of cases. The overall prevalence of anemia, ID, and IDA was: 18.0%, 43.4%, and 12.2%, respectively. The prevalence of all three conditions did not differ between IBD subtypes. ID(A) was observed more frequently in patients with biochemically active IBD than in quiescent IBD (ID: 70.8% versus 23.9%; p < 0.001). Contrary to the guidelines, most respondents prescribed standard doses of intravenous or oral iron regardless of biochemical parameters or inflammation. Lastly, 25% of respondents reported not treating non-anemic ID. Conclusions: One in five patients with IBD suffers from anemia that—despite inconsistently measured iron parameters—is primarily caused by ID. Most medical professionals treat IDA with oral iron or standard doses of intravenous iron regardless of biochemical inflammation; however, non-anemic ID is often overlooked. Raising awareness about the management of ID(A) is needed to optimize and personalize routine care.

Original languageEnglish
Article number6843
JournalJournal of Clinical Medicine
Volume11
Issue number22
DOIs
Publication statusPublished - Nov 2022

Bibliographical note

Funding Information:
The research position of R.L. was supported with an unrestricted grant from Cablon Medical. The sponsoring bodies, except for collaborating authors, had no role in the conceptualization or design of the study, including data collection, analysis, data interpretation, or writing the manuscript.

Publisher Copyright:
© 2022 by the authors.

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