1 Department of Clinical Medicine - The Department of Hepatology and Gastroenterology V, Department of Clinical Medicine, Health, Aarhus University2 Crohn Colitis Center Rhein Main, Frankfurt/Main3 Karolinska University Hospital, Stockholm4 Istituto Clinico Humanitas, Milan5 Medical University Vienna6 Hôpital Charles Nicolle, Rouen7 Hospital de Sao Joan, Porto8 Centro Médico Teknon, Barcelona9 Vifor Pharma, Glattbrugg10 University Medical Center Utrecht11 John Radcliffe Hospital, Oxford12 Department of Clinical Medicine - The Department of Hepatology and Gastroenterology V, Department of Clinical Medicine, Health, Aarhus University
Background: In 2009, a survey on anaemia management in patients with inflammatory bowel disease (IBD) revealed that treatment practice is not in line with treatment recommendations. Despite a high prevalence of severe anaemia and absolute iron deficiency, most patients received oral instead of intravenous (i.v.) iron. Since additional data on effective correction of anaemia with i.v. iron emerged in the meantime (FERGIcor), a new survey was performed in 2011 to evaluate whether treatment practice changed. Methods: Gastroenterologists in France, Germany, Spain, UK and Switzerland completed questionnaires (Jun-Aug 2011) on patient demographics, blood tests at diagnosis and therapies for the last five IBD patients treated for anaemia within six months. Results are totals over all patients and ranges across countries. Results: 142 gastroenterologists (97 hospital-based only) reported 710 cases of IBD-associated anaemia. At the time of the survey, 83% (61-94%) were treated for anaemia (2009: 71% [59-79%]) and almost all of those (96% [2009: 91%]) received iron therapy, mainly as monotherapy (84% [2009: 78%]). Slightly more iron-treated patients but still only (32% [2009: 26%] received i.v. iron. Details of used treatment options and assessed haematological parameters are summarised and compared to the results of the 2009 survey in table 1. Conclusions: Treatment of IBD-associated anaemia in clinical practice did hardly change over the last two years despite new clinical data on the effectiveness of i.v. iron in correcting anaemia, and worse baseline Hb and iron status compared to a prior survey. The on-going lack in awareness of evidence-based recommendations on iron supplementation emphasises the need for new educational strategies to improve implementation of current and upcoming guidelines.