Intravenous Iron Therapy Appears Optimal in Iron Deficiency Anemia With IBD

Treatment with intravenous (IV) iron therapy was safe and effective for improving hemoglobin (Hb) and iron levels in pediatric patients with iron deficiency anemia (IDA) and active inflammatory bowel disease (IBD), according to an observational cohort study led by Krishanth Manokaran, MD, of Boston Children’s Hospital in Massachusetts.

“Correction of IDA appears to occur independent of other biochemical responses to therapy, including changes in inflammatory [erythrocyte sedimentation rate and c-reactive protein] markers,” the researchers reported. “As such, IDA may persist without directed therapy, even in patients who otherwise respond to effective corticosteroid, biologic, or other immunosuppressive therapies.”

IV Iron Treatment Safe in Children With IDA and IBD

The analysis, published in the World Journal of Clinical Pediatrics, included 236 consecutive pediatric patients admitted to the authors’ tertiary IBD care center between September 2017 and December 2019, of whom 92 met prespecified criteria for IDA. Of the 92, 57 received IV iron, 17 received oral iron, and 18 were discharged prior to receiving iron.

According to the authors, patients with IDA who received IV iron therapy while hospitalized exhibited a significant increase in mean Hb concentration of 1.9 ± 0.2 g/dL by the first ambulatory follow-up. Comparatively, patients who received oral iron therapy or no iron therapy each had mean increases of 0.8 ± 0.3 g/dL. The authors noted that one out of 57 (1.8%) patients that received IV iron therapy had an adverse reaction.

“In conclusion, our findings demonstrate that treatment with parenteral iron therapy is most likely to result in a significant improvement in Hb levels in pediatric patients admitted with IBD and IDA,” Dr. Manokaran and colleagues wrote. “Conversely, we found no significant changes in Hb levels in patients receiving oral or no iron therapy.”

Reference

Manokaran K, Spaan J, Cataldo G, et al. Inpatient management of iron deficiency anemia in pediatric patients with inflammatory bowel disease: a single center experience. World J Clin Pediatr. 2024;13(1):89318. 2024. doi:10.5409/wjcp.v13.i1.89318