Iron therapy supplementation in inflammatory bowel disease patients with iron deficiency anemia: findings from a real-world analysis in Italy

EurJGastroenterolHepatol. 2024May1;36(5):563570.doi:10.1097/MEG.0000000000002740. Epub 2024 Mar 1.

Gionata Fiorino 1 2Jean-Frederic Colombel 3Kostas Katsanos 4Fermín Mearin 5Jürgen Stein 6Margherita Andretta 7Stefania Antonacci 8Loredana Arenare 9Rita Citraro 10Stefania Dell'Orco 11Luca Degli Esposti 12Antonio Ramirez de Arellano Serna 13Neige Teldja Morin 13Ioannis E Koutroubakis 14


Author information

1Gastroenterology and Digestive Endoscopy, Vita-Salute San Raffaele University, Milan.

2Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, Rome, Italy.

3Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, USA.

4Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.

5Servicio de Aparato Digestivo, Teknon Medical Center, Barcelona, Spain.

6Department of Gastroenterology and Clinical Nutrition, DGD Clinics Sachsenhausen, Frankfurt, Germany.

7U.O.C. Assistenza Farmaceutica Territoriale, Azienda ULSS 8 Berica, Vicenza.

8U.O.C. Farmacia territoriale, ASL Bari, Bari.

9U.O.C. Farmaceutica Territoriale e Integrativa, ASL Latina, Latina.

10Dipartimento di Scienze della Salute, Università Magna Grecia di Catanzaro, U.O. Farmacologia Clinica e Farmacovigilanza, Azienda Ospedaliero-Universitaria "Mater Domini", Catanzaro.

11U.O.C. Farmaceutica Territoriale, ASL Roma 6, Albano Laziale (RM).

12CliCon S.r.l. Società Benefit Health, Economics & Outcomes Research, Bologna, Italy.

13CSL Vifor, Glattbrugg, ZH, Switzerland.

14Department of Gastroenterology, University Hospital Heraklion, Heraklion, Greece.


Background: This real-world analysis evaluated iron therapy supplementation in inflammatory bowel disease patients with iron-deficiency anemia, considering disease progression and healthcare resource consumption.

Methods: A retrospective observational study was conducted using administrative databases of a pool of Italian healthcare entities, covering about 9.3 million beneficiaries. Between January 2010 and September 2017, adult patients were enrolled in the presence of either hospitalization or active exemption code for ulcerative colitis/Crohn's disease, or one vedolizumab prescription. Iron-deficiency anemia was identified by at least one prescription for iron and/or hospitalization for iron-deficiency anemia and/or blood transfusion (proxy of diagnosis). Patients were divided in untreated and iron-treated during 12-month follow-up and analyzed before and after propensity score matching. Disease progression, was evaluated through inflammatory bowel disease-related hospitalizations and surgeries, and healthcare resource utilization was assessed.

Results: Overall, 1753 patients were included, 1077 (61.4%) treated with iron therapy and 676 (38.6%) untreated. After propensity score matching, 655 patients were included in each group. In unbalanced cohorts, disease progression was significantly reduced in patients receiving iron therapy compared to the untreated (11.0% vs. 15.7%, P < 0.01), and this trend was maintained also after applying propensity score matching. The overall mean cost/patient was significantly lower in iron-treated than untreated (4643€ vs. 6391€, P < 0.01).

Conclusion: The findings of this real-world analysis suggest that iron therapy was associated with significant benefits in inflammatory bowel disease patients with iron-deficiency anemia, in terms of both disease progression and healthcare resource utilization.

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