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P350 SAFIIR: Study of Anemia Following Intravenous Iron Repletion

Rioux, L.C.(1);Bernard, E.J.(1);Bourgault, M.(1);Mondragon, P.(1);Rioux, V.(1);

(1)Centre des Maladies Inflammatoires et Intestinales de Montréal, Gastroenterology, Montréal, Canada

Background

The main objective of this study was to assess the prevalence of anemia and the secondary objectives aimed to evaluate the real-life impact of intravenous iron therapy on anemia correction in patients living with Inflammatory Bowel Disease (IBD).

Methods

We performed a retrospective cohort study of adult patients (18 to 80 years old) with a Crohn’s Disease or Ulcerative Colitis diagnosis who were followed at our clinic between January 2018 and March 2020. Clinical data were obtained from the patients’ electronic medical records. Iron-deficiency anemia was defined as hemoglobin (Hb) < 12,0 g/dL and/or transferrin saturation (TSAT)< 20 % and/or low serum iron  (≤ 10 μmol/L). Intravenous (IV) iron treatment was defined as at least one infusion of iron isomaltoside, iron sucrose, or sodium ferric gluconate. The secondary analyses were performed in terms of IV iron treatments.

Results

Of the cohort of 556 IBD patients, 223 (40.1%) had an anemia diagnosis. Among the latter, 39 patients received an intravenous iron treatment and had laboratory results in the 8 weeks preceding and in the 8 weeks following the treatment. Table 1 shows the response to intravenous iron treatment in patients with baseline Hb < 12,0 g/dL (n=28 patients, 47 IV iron infusions). Table 2 shows the changes in anemia-related laboratory values in the 8 weeks preceding and in the 8 weeks following intravenous iron treatment.

Table 1: Impact of intravenous iron therapy on anemia correction

Response to intravenous iron treatmentn (%)
Complete response a26 (55,32)
Partial response b6 (12,77)
No response c15 (31,91)

a A complete response was defined as the proportion of intravenous iron treatments that resulted in a correction of anemia (Hb ≥ 12,0 g/dL or an increase in Hb ≥ 2,0 g/dL)

b A partial response was defined as the proportion of intravenous iron treatments that resulted in an increase of Hb ≥ 1,0 g/dL and < 2,0 g/dL without anemia correction).

c No response was defined as or an increase in Hb < 2,0 g/dL without anemia correction.

Table 2: Changes in anemia-related laboratory values following intravenous iron treatment

Parameter - median (Q1; Q3)Before IV iron treatmentAfter IV iron treatmentChange
Hb, g/dL (n = 47)10,4 (9,2 ; 10,9)11,8 (10,6 ; 12,8)1,5 (0,5 ; 2,4)
TSAT, % (n = 46)7,0 (5,0 ; 11,0)17,0 (8,0 ; 25,0)6,5 (2,0 ; 18,0)
Serum iron,  μmol/L (n = 47)5,0 (2,4 ; 6,7)9,9 (5,0 ; 14,4)4,0 (1,0 ; 10,0)

Conclusion

This was the first study to evaluate the prevalence of iron-deficiency anemia and the real-life impact of intravenous iron treatment among patients living with IBD in Quebec, Canada. The findings will serve as a baseline for subsequent interventions to improve the wellbeing and the quality of life of IBD patients with anemia.

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