Drugs

, Volume 73, Issue 16, pp 1761–1770

Current Management of Iron Deficiency Anemia in Inflammatory Bowel Diseases: A Practical Guide

Therapy in Practice

DOI: 10.1007/s40265-013-0131-2

Cite this article as:
Gomollón, F. & Gisbert, J.P. Drugs (2013) 73: 1761. doi:10.1007/s40265-013-0131-2

Abstract

Anemia and iron deficiency anemia are very common in inflammatory bowel disease (IBD). In most cases, anemia is a consequence of mixed pathogenesis; inflammation and iron deficiency being the most important factors. Iron status should be evaluated carefully, as ferritin is unreliable in the presence of inflammation. It is always necessary to control disease activity; however, supplementation is usually required to fully correct iron deficiencies. Oral iron, intravenous iron, erythropoietin, and blood transfusions can be used in different clinical scenarios. Oral iron may be used in mild cases if the disease has no clinical activity. Intravenous iron should be preferred where oral iron is poorly tolerated or where it has failed in moderate to severe anemia, and in combination with erythropoietin. Iron sucrose is very safe and effective, but not very convenient, as the total needed dose must be divided into several infusions. Ferric carboxymaltose is much more convenient, and has been shown to be more effective than iron sucrose in a large randomized trial. Iron isomaltose shows theoretical promise, but very limited data are available from IBD populations. Blood transfusion can be necessary, especially in acute life-threatening situations, but the trigger for indication should be in the low range. With the correct use of available resources, anemia and iron deficiency should be well controlled in practically all IBD patients.

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.IBD UNIT, Digestive Diseases Service, Hospital Clínico Universitario “Lozano Blesa”, Instituto de Investigación Sanitaria de Aragón (IIS)Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)ZaragozaSpain
  2. 2.IBD UNIT, Digestive Diseases Service, Hospital Universitario “La Princesa”, Instituto de Investigación Sanitaria Princesa (IP)Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)MadridSpain