Dig Liver Dis. 2024 Sep;56(9):1483-1489. doi: 10.1016/j.dld.2024.01.176.Epub 2024 Jan 30.

Gaetano Bergamaschi ¹, Fabiana Castiglione ², Renata D'Incà ³, Marco Astegiano ⁴, Walter Fries ⁵, Monica Milla ⁶, Carolina Ciacci ⁷, Fernando Rizzello ⁸, Simone Saibeni ⁹, Rachele Ciccocioppo ¹⁰, Ambrogio Orlando ¹¹, Fabrizio Bossa ¹², Mariabeatrice Principi ¹³, Piero Vernia ¹⁴, Chiara Ricci ¹⁵, Maria L Scribano ¹⁶, Giorgia Bodini ¹⁷, Dario Mazzucco ¹⁸, Gabrio Bassotti ¹⁹, Gabriele Riegler ²⁰, Andrea Buda ²¹, Matteo Neri ²², Flavio Caprioli ²³, Fabio Monica ²⁴, Aldo Manca ²⁵, Erica Villa ²⁶, Gionata Fiorino ²⁷, Nicola Aronico ²⁸, Marco V Lenti ²⁸, Caterina Mengoli ²⁸, Anna Testa ², Maurizio Vecchi ²³, Catherine Klersy ²⁹, Antonio Di Sabatino ³⁰; RIDART I investigators

Collaborators

• RIDART I investigators: 

Giuseppe Amodeo ¹⁰, Elisabetta Antonelli ¹⁹, Noemi Bertetti ¹⁴, Cristina Bezzio ⁹, Michele Campigotto ²⁴, Roberta Caccaro ³, Manuela De Bona ²¹, Cristina Della Corte ⁹, Maria G Demarzo ³¹, Giuliano Falasco ¹⁶, Rosanna Fontana ¹², Paolo Gionchetti ⁸, Paola Iovino ⁷, Federica Lepore ²⁸, Greta Lorenzon ³, Veronica Marasco ⁶, Alessandro Paolini ²⁴, Lucienne Pellegrini ², Alberto Pieraccini ³², Tiziana Pinto-Vraca ⁵, Davide Ribaldone ⁴, Giulia Rizzuto ¹¹, Jenny Roselli ⁶, Giovanni Santacroce ²⁸, Alessia Todeschini ¹³, Marta Vernero ⁴, Anna Viola ⁵, Irene Zammarchi ¹⁵

Author information

¹Medicina Generale I, Fondazione IRCCS Policlinico San Matteo e Università di Pavia, 27100 Pavia, Italy. Electronic address: gaetanobergamaschi@gmail.com.

²Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, 80138 Naples, Italy.

³Inflammatory Bowel disease Unit- AO-University of Padua, 35122 Padova, Italy.

⁴Gastroenterology and Digestive Endoscopy Unit, "Città della Salute e della Scienza" Hospital, 10126 Torino, Italy.

⁵Gastroenterology and Clinical Unit for inflammatory bowel diseases, Dept. of Clinical and Experimental Medicine; University of Messina, 98122 Messina, Italy.

⁶Unità operativa complessa di Gastroenterologia clinica, Azienda ospedaliero universitaria Careggi- Firenze, 50134 Firenze, Italy.

⁷Gastroenterology and Endoscopy Unit, AOU San Giovanni di Dio e Ruggi d'Aragona and University of Salerno, 84084 Salerno, Italy.

⁸Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

⁹Gastroenterology Unit, Rho Hospital, ASST Rhodense, 20017 Rho (MI), Italy.

¹⁰Gastroenterology Unit, Department of Medicine, A.O.U.I. Policlinico G.B. Rossi & University of Verona, 37134 Verona, Italy.

¹¹Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello", 90146 Palermo Italy.

¹²Department of Gastroenterology and Endoscopy, Fondazione "Casa Sollievo della Sofferenza", IRCCS, 71013 San Giovanni Rotondo, Italy.

¹³Gastroenterology Unit (D.E.T.O.), University of Bari, 70121 Bari, Italy.

¹⁴Division of Gastroenterology, Department of Translational and Precision Medicine, "Sapienza" University of Rome and Umberto I Hospital, 00161 Rome, Italy.

¹⁵Dept of Experimental and Clinical Science, University of Brescia, Gastroenterology Unit,Spedali Civili Hospital, 25123 Brescia. Italy.

¹⁶Gastroenterology and Endoscopy Unit, Azienda Ospedaliera San Camillo-Forlanini, 00152 Rome, Italy; Villa Stuart, Multi-Speciality Clinic, 00135 Rome, Italy.

¹⁷Gastroenterology unit, Department of Internal medicine, Policlinico San Martino, Università di Genova, 16132 Genoa, Italy.

¹⁸Gastroenterology Unit, ASL TO3, 10097 Rivoli, Torino, Italy.

¹⁹Gastroenterology, Hepatology & Digestive Endoscopy Section, Department of Medicine & Surgery, University of Perugia and Perugia General Hospital, 06129 Perugia, Italy.

²⁰Unit of Gastroenterology - Reference Center for IBD - Second University of Naples, 80138 Naples, Italy.

²¹Department of Gastrointestinal Oncological Surgery, Gastroenterology Unit, S. Maria del Prato Hospital, 30032 Feltre, Italy.

²²Department of Medicine and Ageing Sciences and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy.

²³Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano, 20122 Milan, Italy.

²⁴Gastroenterology and Digestive Endoscopy Unit, Cattinara Academic Hospital, 34149 Trieste, Italy.

²⁵Department of Gastroenterology and Digestive Endoscopy, S. Croce e Carle Hospital, 12100 Cuneo, Italy.

²⁶UC Gastroenterologia, Dipartimento di Specialità Mediche, Azienda Ospedaliera Universitaria di Modena, 41125 Modena, Italy.

²⁷Department of Gastroenterology and Digestive Endoscopy, San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy; IBD Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy.

²⁸Medicina Generale I, Fondazione IRCCS Policlinico San Matteo e Università di Pavia, 27100 Pavia, Italy.

²⁹Servizio di Epidemiologia Clinica & Biometria, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.

³⁰Medicina Generale I, Fondazione IRCCS Policlinico San Matteo e Università di Pavia, 27100 Pavia, Italy. Electronic address: a.disabatino@smatteo.pv.it.

³¹Gastroenterology and Clinical Unit for inflammatory bowel diseases, Dept. of Clinical and Experimental Medicine; University of Messina, 98122 Messina, Italy; Gastroenterology unit, Department of Internal medicine, Policlinico San Martino, Università di Genova, 16132 Genoa, Italy.

³²UO Gastroenterologia ed Endoscopia Digestiva, Ospedale San Jacopo, 51100 Pistoia, Italy.

Abstract

Background: The RIDART I study found a 13.6% prevalence of anemia in Italian patients with inflammatory bowel disease (IBD); most cases were due to iron-deficiency anemia (IDA).

Aims: To evaluate changes in hemoglobin concentration during a 24-week follow-up of anemic patients with IBD.

Methods: Follow-up laboratory and clinical data were obtained from RIDART I study patients with anemia. Factors affecting hemoglobin concentration, the impact of anemia on fatigue and quality of life (QoL), and its relationship with treatment, disease activity and disease complications were investigated.

Results: Hemoglobin was 108 g/L at baseline, increased to 121 g/L at follow-up week 12 (p < 0.001) and then stabilized until week 24, but most patients remained anemic, with IDA, throughout the study. Hemoglobin improvement was greater in patients receiving either oral or parenteral iron supplementation. Following hemoglobin normalization, anemia relapse rate during follow-up was 30%. Oral iron did not cause disease reactivation. Lower follow-up hemoglobin was associated with a higher probability of having active disease, clinical complications, increased fatigue and reduced QoL.

Conclusions: In anemic patients with IBD, anemia represents a long-lasting problem, in most cases persisting for up to 24 weeks, with high relapse rate and a negative impact on fatigue and QoL.