Current practice in the diagnosis and management of IBD-associated anaemia and iron deficiency in Germany: the German AnaemIBD Study.
OBJECTIVE
Anaemia is a common complication in inflammatory bowel disease (IBD), frequently resulting from iron deficiency. IBD guidelines advocate intravenous iron administration although some patients respond to oral supplementation. This non-interventional study investigates the current status of anaemia management in German IBD patients.


METHODS
Baseline data on pre-study treatment for anaemia were retrospectively analysed in IBD patients with anaemia participating in a prospective trial of the efficacy and safety of ferric carboxymaltose. Data were collected from 55 German gastroenterological centres up to August 2010. Subjects had received care at their centre for at least 12 months prior to baseline.


RESULTS
193 cases of IBD-associated anaemia (115 Crohn's disease, 77 ulcerative colitis) were analysed (mean age: 39 years (18-83), 79 (41%) males). Anaemia and iron status were usually assessed by haemoglobin (100%), serum ferritin (97%), and transferrin saturation (82%). In the previous 6 months, only 84 patients (43.5%) had been treated for anaemia: 47 (56%) with oral iron, 13 (15%) parenteral iron, 16 (19%) oral plus parenteral iron and 8 (10%) transfusions. No patients received erythropoietin stimulating agents.


CONCLUSIONS
Although intravenous iron supplementation is recommended in IBD patients, current German practice still relies on oral therapy, even in severe anaemia. The high incidence of severe anaemia in this cohort reflects inadequate iron replacement and status monitoring. While the proportion of IBD patients with inadequately treated anaemia/iron deficiency is unknown, greater awareness of existing guidelines for iron deficiency management in IBD patients appears necessary.
Medical Dpt. 1, Frankfurt University Hospital, Frankfurt am Main, Germany.
Irina
I
Blumenstein
Crohn Colitis Centre Rhein-Main, Frankfurt am Main, Germany; Agaplesion Markus Hospital, Frankfurt am Main, Germany.
Axel
A
Dignass
Gastroenterological Practice, Goeppingen, Germany.
Stephan
S
Vollmer
Gastroenterological Practice, Cottbus, Germany.
Wolfgang
W
Klemm
Vifor Pharma Germany GmbH, Munich, Germany.
Susanne
S
Weber-Mangal
Crohn Colitis Centre Rhein-Main, Frankfurt am Main, Germany; Hospital Sachsenhausen, Frankfurt am Main, Germany. Electronic address: J.Stein@em.uni-frankfurt.de.
Juergen
J
Stein
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D001803:Blood Transfusion; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005293:Ferritins / Q000097:blood; D005858:Germany; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014168:Transferrin / Q000378:metabolism; D055815:Young Adult
D006454:Hemoglobins; D014168:Transferrin; D005293:Ferritins; D007501:Iron
Anaemia;; Inflammatory bowel disease;; Iron deficiency;; Iron supplementation