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N08 Real-world experience: Treatment of iron deficiency anaemia (IDA) with intravenous (IV) iron in inflammatory bowel disease

J. Kearns*1, S. Jacob1

1Northern Trust, Gastroenterology, Antrim, UK

Background

IDA is common in patients with inflammatory bowel diseases, and the relevant ECCO 2015 Guidelines recommend IV iron as first-line treatment in patients with active disease, severe anaemia or unable to tolerate oral iron. Iron isomaltoside is an IV iron introduced to our hospital in October-16, and it allows delivery of high doses of up to 20 mg of iron per kg of body weight in a single administration. The purpose of this study was to evaluate our anaemia treatment service.

Methods

The medical records of patients who received iron isomaltoside between 16 October and 18 April were retrospectively examined, and data on demographics, IV iron dose, haemoglobin (Hb)/ iron parameters and adverse drug reactions (ADRs) was collected.

Results

A total of 90 patients were treated in the 18-month audit period; 65/90 (72%) were females. Twenty-six of 90 (29%) patients were on concomitant biological treatment, 4/90 (4%) on thiopurine and 7/90 (8%) on mesalazine. Mean patient weight was 68 (range: 35–121) kg, baseline Hb 100 (26–144) g/l and ferritin 28 (2–160) μg/l. Mean prescribed IV iron dose was 1292 mg, 44/90 (49%) patients were prescribed >1000 mg of iron, and 66% of patients received their total prescribed dose in one administration, while 16 fewer administrations took place compared with the administrations that would have been needed with our previous IV iron. At 1-month post-administration, mean Hb rose by 23 g/l to 123 (84–162) g/l, and ferritin by 60 μg/l to 88 (19–464) μg/l. At 6-months, mean Hb was maintained at 122 (73–161) g/l and ferritin further increased to 115 (12–452) μg/l. A total 2/120 (1.7%) of ADRs took place; none was serious, and the infusion was completed successfully in all patients.

Conclusion

Patients with gastroenterological diseases have high iron needs. Mean Hb increased satisfactorily post-IV infusion and was maintained at 6-months post-administration. Iron isomaltoside was an effective, well-tolerated and resource-saving treatment.