title: Anemia and iron deficiency in inflammatory bowel disease: an open, prospective, observational study on diagnosis, treatment with ferric carboxymaltose and quality of life.
abstract: OBJECTIVE
  Iron deficiency and anemia are being increasingly recognized as a complication of inflammatory bowel disease (IBD). The aim of this study was to observe, in a non-interventional way, how Swedish gastroenterologists adhere to guidelines in IBD outpatients treated with intravenous ferric carboxymaltose (FCM), and the result of treatment.
  
  
  METHODS
  Altogether 394 IBD patients (Crohn's disease (CD) 60%, ulcerative colitis (UC) 40%) from 14 centers were included. Group A (n = 216) was observed from November 2008 and group B (n = 178) from March 2010. Time of observation ranged from 12 to 29 months.
  
  
  RESULTS
  S-Ferritin (µmol/l) and transferrin saturation (T-Sat; %) were recorded at baseline in 62% and 50% in group A. Median values for Hb, ferritin and T-Sat at baseline were 111 g/l, 10 µmol/l and10%, respectively, and 134 g/l, 121 µmol/l and 20% after iron treatment (p < 0.001 for all three parameters). Similar results were found in group B. Approximately three-quarters of all patients had only one iron infusion during the study period. Median time to reinfusion was 6 (1-25) months. Only previously described infusion reactions occurred in 27 (7%) patients.
  
  
  CONCLUSIONS
  Adherence to European guidelines was rather poor and needs to be improved. The effect on iron parameters of intravenous FCM was significant, and resulted in a ferritin level that indicates an effect on the iron stores. The effect was mostly sustained for a year since only one-quarter of the patients were given repeated iron infusions. No unforeseen safety concerns emerged during the observation period.
authors.affiliation: Department of Gastroenterology and Hepatology, Karolinska University Hospital, 17176 Stockholm, Sweden. ragnar.befrits@karolinska.se
authors.forename: Ragnar
authors.initials: R
authors.lastname: Befrits
authors.forename: Ola
authors.initials: O
authors.lastname: Wikman
authors.forename: Lars
authors.initials: L
authors.lastname: Blomquist
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjortswang
authors.forename: Per
authors.initials: P
authors.lastname: Hammarlund
authors.forename: Antal
authors.initials: A
authors.lastname: Bajor
authors.forename: Daniel
authors.initials: D
authors.lastname: Klintman
authors.forename: Håkan
authors.initials: H
authors.lastname: Blom
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003093:Colitis, Ulcerative / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D004909:Erythrocyte Indices; D005260:Female; D005290:Ferric Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D005293:Ferritins / Q000097:blood; D019983:Guideline Adherence; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D000090463:Iron Deficiencies; D008297:Male; D008320:Maltose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011788:Quality of Life; D013548:Sweden; D014168:Transferrin / Q000378:metabolism; D055815:Young Adult
chemical_list: D005290:Ferric Compounds; D006397:Hematinics; D006454:Hemoglobins; D014168:Transferrin; C522335:ferric carboxymaltose; D008320:Maltose; D005293:Ferritins