Robin Dalal, MD, Christopher Coe, MD, Matthew Meyers, MD, Ailish Garrett, APN, Caroline Duley, APN, Julianne Wagnon, APN, JD, Kim Annis, PA-C, Elizabeth Scoville, MD, MSCI, Dawn B. Beaulieu, MD, David A. Schwartz, MD, FACG, Sara Horst, MD, MPH
Vanderbilt University Medical Center, Nashville, TN
Introduction: Iron deficiency anemia (IDA) is a common extra-intestinal complication of inflammatory bowel disease (IBD) which includes both Crohn’s disease (CD) and Ulcerative Colitis (UC). The objective of this study was to evaluate the effects of gastroenterologist-led management of IDA in the IBD population.
Methods: A retrospective chart review was conducted at a single tertiary care inflammatory bowel disease center. All patients with proven IBD (CD or UC) and anemia (defined as hemoglobin (Hgb) < 12 for women and < 13 for men) treated through the IBD center with standard regimens of intravenous iron (iron sucrose 200 x 5 doses, ferric carboxymaltose 750mg x 2 doses, ferumoxytol 510mg x 2 doses) were included. Statistical analysis was performed using paired t test, pearson chi-squared test, and Wilcoxon rank sum test.
Results: 351 pts (249 pts with CD, 102 pts with UC) were evaluated. Median age was 33 (IQR 25, 46) and 62% were female. The majority of pts (79%, n = 251) had active endoscopic disease prior to treatment for IDA. 60% of pts were on biologic therapy and 27% were on corticosteroids. Hgb and iron increased significantly after iron treatment in both CD and UC as seen in Table 1. SIBDQ improved significantly in both CD and UC as seen in Figure 1. After iron treatment, 41.2% of pts had resolution of IDA. Male pts were more likely to remain anemic than female pts (p = 0.016 using pearson chi-squared test); age and IBD type (CD vs. UC) did not affect anemia persistence. 53% of pts were re-treated with iron infusions. 3% of pts required blood transfusions for IDA. Only 8% of pts required hematology referral.
Discussion: In a large cohort of pts with IBD, IDA improves after gastroenterologist-led treatment but persists in the majority of pts, especially male pts. Treatment of IDA improves pts quality of life. Over half of pts required re-treatment. Only a minority of pts required hematology referral for management of IDA.
Citation: Robin Dalal, MD, Christopher Coe, MD, Matthew Meyers, MD, Ailish Garrett, APN, Caroline Duley, APN, Julianne Wagnon, APN, JD, Kim Annis, PA-C, Elizabeth Scoville, MD, MSCI, Dawn B. Beaulieu, MD, David A. Schwartz, MD, FACG, Sara Horst, MD, MPH. P2277 - GASTROENTEROLOGIST-LED MANAGEMENT OF IRON DEFICIENCY ANEMIA - A TERTIARY CARE EXPERIENCE. Program No. P2277. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.