However , in patients with IBD flares and inadequate responses to or side effects with oral preparations , intravenous iron supplementation is the therapy of choice .
Neither oral nor intravenous therapy seems to exacerbate the clinical course of IBD , and intravenous iron therapy can be administered even in active disease stages and concomitantly with biologics .
Based on the data presented , oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency  anemia unless such patients are intolerant or have an inadequate response , whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron
Abstract Anemia is the most frequent complication of inflammatory bowel disease ( IBD ) , but anemia , mostly due to iron deficiency , has long been neglected in these patients .
The aim was to briefly present the pathophysiology , followed by a balanced overview of the different forms of iron replacement available , and subsequently , to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD .
Ferric Maltol Is Effective in Correcting Iron Deficiency Anemia in Patients with Inflammatory Bowel Disease: Results from a Phase-3 Clinical Trial Program
Background : Iron deficiency anemia ( IDA ) is frequently seen in inflammatory bowel disease . Traditionally , oral iron supplementation is linked to extensive gastrointestinal side effects and possible disease exacerbation . This multicenter phase-3 study tested the efficacy and safety of ferric maltol , a complex of ferric ( Fe3 + ) iron with maltol ( 3-hydroxy-2-methyl-4-pyrone ) , as a novel oral iron therapy for IDA . Methods : Adult patients with quiescent or mild-to-moderate ulcerative colitis or Crohn 's disease , mild-to-moderate IDA ( 9.5–12.0 g/dL and 9.5–13.0 g/dL in females and males , respectively ) , and documented failure on previous oral ferrous products received oral ferric maltol capsules ( 30 mg twice a day ) or identical placebo for 12 weeks according to a r and omized , double-blind , placebo-controlled study design . The primary efficacy endpoint was change in hemoglobin ( Hb ) from baseline to week 12 . Safety and tolerability were assessed . Results : Of 329 patients screened , 128 received r and omized therapy ( 64 ferric maltol-treated and 64 placebo-treated patients ) and comprised the intent-to-treat efficacy analysis : 55  ferric maltol patients ( 86 % ) and 53 placebo patients ( 83 % ) completed the trial . Significant improvements in Hb were observed with ferric maltol versus placebo at weeks 4 , 8 , and 12 : mean ( SE ) 1.04 ( 0.11 ) g/dL , 1.76 ( 0.15 ) g/dL , and 2.25 ( 0.19 ) g/dL , respectively ( P < 0.0001 at all time-points ; analysis of covariance ) . Hb was normalized in two-thirds of patients by week 12 . The safety profile of ferric maltol was comparable with placebo , with no impact on inflammatory bowel disease severity . Conclusions : Ferric maltol provided rapid clinical ly meaningful improvements in Hb and showed a favorable safety profile , suggesting its possible use as an alternative to intravenous iron in IDA inflammatory bowel disease
However , in patients with IBD flares and inadequate responses to or side effects with oral preparations , intravenous iron supplementation is the therapy of choice .
Neither oral nor intravenous therapy seems to exacerbate the clinical course of IBD , and intravenous iron therapy can be administered even in active disease stages and concomitantly with biologics .
Based on the data presented , oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency  anemia unless such patients are intolerant or have an inadequate response , whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron
Abstract Anemia is the most frequent complication of inflammatory bowel disease ( IBD ) , but anemia , mostly due to iron deficiency , has long been neglected in these patients .
The aim was to briefly present the pathophysiology , followed by a balanced overview of the different forms of iron replacement available , and subsequently , to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD .