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P643. Anemia in patients with inflammatory bowel disease - A nationwide cross-sectional study

Background

Anemia is the most common complication in patients with inflammatory bowel disease (IBD). The therapeutic strategy for the treatment of anemia in patients with IBD is fundamental in the management of this pathology. This study aims to assess the number of patients with IBD who have anemia and to enhance knowledge of its profile nationally.

Methods

An observational cross-sectional multicenter evaluation was conducted. We included all patients who had an appointment at the 15 participating centers during the period of 1 month and who met the following selection criteria: age ≥18 years, diagnosis of IBD; informed consent for study participation. Disease activity was evaluated by Harvey–Bradshaw Index (HBI) for Crohn's disease (CD) and Simple Clinical Colitis Activity Index (SCCAI) for Ulcerative Colitis (UC). Statistical analysis: chi-squared test for categorical variables, and t-test for independent continuous variables.

Results

We included 1313 patients, 54.8% female, mean age 42.8 years (standard deviation 15.1 years), 59% had a diagnosis of Crohn's disease, 39% of Ulcerative Colitis and 2% IBD unclassified. The median follow up since diagnosis was 7 years. The actual treatment was aminosalicylates (63.1%), steroids (11.6%), immuno-suppressors (36.4%) and anti-TNF (27.3%).

Anemia was identified in 244 patients, representing a prevalence of 18.6% (95% CI 16.6, 20.9%); The majority of cases (91.9%) were mild (Hb ≥10 g/dL), mean Hb 11.3±0.8 g/dL. The number of cases of anemia was significantly higher in females (p = 0.006). There were no differences between Crohn's disease's (19.1%) and Ulcerative Colitis's (17.7%) (p = 0.688). Anemia was more frequent in patients with active disease (HBI >4; SCCAI >2) than in those in clinical remission (34% vs 16%, p < 0.001) and in patients on steroids (36.8%) versus other treatments (p < 0.001). Only 47% of patients with anemia were receiving any specific treatment (oral iron 67%; IV iron 41%).

Conclusion

The percentage of patients with anemia at one time-point was lower than those presented in other studies. The treatment of anemia is undervalued, whereas more than half of anemic patients were not receiving any specific treatment and the use of oral iron prevails contrary to the recommendations.

  • Written by:

    F. Portela1, J. Cotter2, H. Vasconcelos3, P. Ministro4, P. Caldeira5, H. Morna6, H. Sousa7, P. Peixe8, A. Duarte9, I. Cremers10, J. Deus11, M. Cravo12, P. Lago13, S. Lopes14, R. Gonçalves15, A. Belo16, F. Magro14, 1Centro Hospitalar Universitário de Coimbra and GEDII, Gastroenterology, Coimbra, Portugal, 2Centro Hospitalar do Alto Ave and GEDII, Gastroenterology, Guimarães, Portugal, 3Hospital Santo André and GEDII, Gastroenterology, Leiria, Portugal, 4Centro Hospitalar Tondela Viseu and GEDII, Gastroenterology, Viseu, Portugal, 5Hospital Faro and GEDII, Gastroenterology, Faro, Portugal, 6Hospital Funchal and GEDII, Gastroenterology, Funchal, Portugal, 7Hospital de Portimão and GEDII, Gastroenterology, Portimão, Portugal, 8Hospital Egas Moniz and GEDII, Gastroenterology, Lisboa, Portugal, 9Hospital do Divino Espirito Santo and GEDII, Gastroenterology, Ponta Delgada, Portugal, 10Hospital de Setúbal and GEDII, Gastroenterology, Setúbal, Portugal, 11Hospital Fernando da Fonseca and GEDII, Gastroenterology, Amadora, Portugal, 12Hospital Beatriz Ângelo and GEDII, Gastroenterology, Loures, Portugal, 13Hospital Sto António and GEDII, Gastroenterology, Porto, Portugal, 14Hospital S. João and GEDII, Gastroenterology, Porto, Portugal, 15Hospital de Braga and GEDII, Gastroenterology, Braga, Portugal, 16OM Pharma, Medical Department, Lisboa, Portugal