Year 2018 / Volume 110 / Number 3
Original
Managing iron deficiency and iron deficiency anemia in inflammatory bowel disease. The results of the “Gestiona hierro-EII” survey

172-178

DOI: 10.17235/reed.2018.5354/2017

Francesc Casellas Jordá, Isabel Vera Mendoza, Manuel Barreiro-de Acosta, Juan María Vázquez Morón, Javier López Román, Javier Júdez Gutiérrez,

Abstract
Introduction: iron deficiency anemia is a common and very relevant manifestation of inflammatory bowel disease (IBD). Although clinical practice guidelines have been published and updated on this subject, the management in the daily practice of this complication is far from optimal. Objective: to determine the actual management, needs and limitations of anemia in IBD by means of a survey of gastroenterology specialists. Material and methods: a self-administered telematic survey was carried out between April and May 2017 and was sent to SEPD members. The survey included four sections: participant demographics, monitoring, treatment and limitations/needs. Results: a total of 122 evaluable surveys were received from all Spanish autonomous communities. Iron deficiency anemia is considered as a frequent manifestation of IBD and is monitored in all patients via the measurement of hemoglobin and ferritin. In the case of anemia, the survey respondents found it necessary to rule out the presence of IBD activity. However, only 14.8% prescribed intravenous iron when IBD was active. The required dose of intravenous iron is mainly calculated according to patient needs but only 33.1% of clinicians infused doses of 1 g or more. Conclusions: the “Gestiona Hierro EII” survey on the management of anemia in IBD demonstrated a high quality of care, even though some aspects need to be improved. These included the prescription of intravenous iron for patients with disease activity, the use of high-dose intravenous iron and the implementation of algorithms into clinical practice.
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References
1. Gisbert JP, Gomollón F. Common misconceptions in the diagnosis and management of anemia in inflammatory bowel disease. Am J Gastroenterol 2008;103:1299-307.
2. Vegh Z, Kurti Z, Gonczi L, et al. Association of extraintestinal manifestations and anaemia with disease outcomes in patients with inflammatory bowel disease. Scand J Gastroenterol. 2016;51:848-54.
3. Koutroubakis IE, Ramos-Rivers C, Regueiro M, et al. Persistent or recurrent anemia is associated with severe and disabling Inflammatory Bowel Disease. Clin Gastroenterol Hepatol. 2015 Oct;13(10):1760-6.
4. Wells CW, Lewis S, Barton JR, et al. Effects of changes in hemoglobin level on Quality of Life and cognitive function in Inflammatory Bowel Disease patients. Inflamm Bowel Dis 2006;12:123-130.
5. Herrera-deGuise C, Casellas F, Robles V, et al. Iron Deficiency in the absence of anemia impairs the perception of health-related Quality of Life of patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2016;22:1450-5.
6. Casellas F, Herrera-de Guise C, Robles V, et al. Patient preferences for Inflammatory Bowel Disease treatment objectives. Dig Liver Dis. 2017;49:152-156.
7. Sjöberg D, Holmström T, Larsson M, et al. Anemia in a population-based IBD cohort (ICURE): still high prevalence after 1 year, especially among pediatric patients. Inflamm Bowel Dis. 2014;20:2266-70.
8. Blumenstein I, Dignass A, Vollmer S, et al. Current practice in the diagnosis and management of IBD-associated anaemia and iron deficiency in Germany: the German AnaemIBD Study. J Crohns Colitis. 2014;8:1308-14.
9. Danese S, Hoffman C, Vel S, et al. Anaemia from a patient perspective in Inflammatory Bowel Disease: results from the European Federation of Crohn's and Ulcerative Colitis Association's online survey. Eur J GastroenterolHepatol. 2014;26:1385-91.
10. Van Biervliet S, Smets F, Hofmann I, et al. The course of anaemia in children and adolescents with Crohn's disease included in a prospective registry. Int J Colorectal Dis. 2015;30:51-6.
11. Dignass AU, Gasche C, Bettenworth D, et al; European Crohn’s and Colitis Organisation [ECCO]. European consensus on the diagnosis and management of iron deficiency and anaemia in Inflammatory Bowel Disease. J Crohns Colitis. 2015;9:211-22.
12. Stein J, Bager P, Befrits R, et al. Anaemia management in patients with Inflammatory Bowel Disease: routine practice across nine European countries. Eur J Gastroenterol Hepatol. 2013;25:1456-63.
13. Mearin F, Barreiro-de Acosta M, González-Galilea Á, et al; en nombre del Grupo de Investigadores del Estudio REGIS. Prevalence and characteristics of anemia and iron deficiency in patients hospitalized for gastrointestinal diseases in Spain. Gastroenterol Hepatol. 2013;36:499-507.
14. Barreiro-de Acosta M, Argüelles-Arias F, Hinojosa J, et al. ¿Cómo se maneja la enfermedad inflamatoria intestinal en los servicios de digestivos en España?. Resultados de la Encuesta GESTIONA-EII. Rev Esp Enferm Dig 2016;108:618-26.
15. Ferreiro R, Barreiro M, Seijo-Ríos S, et al. Eficacia del hierro intravenoso en el tratamiento de la anemia ferropénica en pacientes con Enfermedad Inflamatoria Intestinal. ¿Existen factores predictivos de respuesta?. Rev Esp Enferm Dig 2011:103:245-9.
16. Mei Z, Cogswell ME, Parvanta I, et al. Hemoglobin and ferritin are currently the most efficient indicators of population response to iron interventions: an analysis of nine randomized controlled trials. J Nutr 2005:135:1974-80.
17. Gomollón F, Chowers Y, Danese S, et al. Letter: European Medicines Agency recommendations for allergic reactions to intravenous iron-containing medicines. Aliment Pharmacol Ther 2014;39:743-4.
18. Aksan A, Işık H, Radeke HH, et al. Systematic review with network meta-analysis: comparative efficacy and tolerability of different intravenous iron formulations for the treatment of iron deficiency anaemia in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2017;45:1303-18.
19. Dahlerup JF, Jacobsen BA, van der Woude J, et al. High-dose fast infusion of parenteral iron isomaltoside is efficacious in Inflammatory Bowel Disease patients with iron-deficiency anaemia without profound changes in phosphate or fibroblast growth factor 23. Scand J Gastroenterol. 2016;51:1332-8.
20. Cano N, Oltra L, Hinojosa J. Estudio comparativo de 2 formulaciones de hierro intravenoso en una Unidad de Hospital de Día. Enferm Inflam Intest Dia 2016;15:10-4.
21. Rey, E, Mascort JJ, Peña E, et al, para la SEPD, semFYC, SEMERGEN y SEMG. Manejo del problema clínico del estreñimiento con molestias abdominales en adultos. Encuesta nacional en Atención Primaria y Aparato Digestivo. Rev Esp Enfer Dig 2016; 18(6): 323-331.
22. Fernández-Urién I, Argüelles F, Alonso P, et al. A survey-based analysis on endoscopic quality indicators compliance among Spanish endoscopists. Rev Esp Enfer Dig 2017; 19(1): 33-48.
New recommendations to manage risk of allergic reactions with intravenous iron-containing medicines. EMA/377372/2013 (News release). Accesible en: http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2013/06/WC500144874.pdf
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Casellas Jordá F, Vera Mendoza I, Barreiro-de Acosta M, Vázquez Morón J, López Román J, Júdez Gutiérrez J, et all. Managing iron deficiency and iron deficiency anemia in inflammatory bowel disease. The results of the “Gestiona hierro-EII” survey. 5354/2017


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Publication history

Received: 02/11/2017

Accepted: 21/01/2018

Online First: 21/02/2018

Published: 28/02/2018

Article revision time: 61 days

Article Online First time: 111 days

Article editing time: 118 days


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