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 .
Iron Supplementation and Mortality in Incident Dialysis Patients: An Observational Study
Background Studies on the association between iron supplementation and mortality in dialysis patients are rare and conflicting . Methods In our observational single-center cohort study ( INVOR study ) we prospect ively studied 235 incident dialysis patients . Time-dependent Cox proportional hazards models using all measured laboratory values for up to 7.6 years were applied to study the association between iron supplementation and all-cause mortality , cardiovascular and sepsis-related mortality . Furthermore , the time-dependent association of ferritin levels with mortality in patients with normal C-reactive protein ( CRP ) levels ( < 0.5 mg/dL ) and elevated CRP levels ( ≧0.5 mg/dL ) was evaluated by using non-linear P-splines to allow flexible modeling of the association . Results One hundred and ninety-one ( 81.3 % ) patients received intravenous iron , 13 ( 5.5 % ) patients oral iron , whereas 31 ( 13.2 % ) patients were never supplemented with iron throughout the observation period . Eighty-two ( 35 % ) patients died during a median follow-up of 34 months , 38 patients due to cardiovascular events and 21 patients from sepsis . Baseline CRP levels were not different between patients with and without iron supplementation . However , baseline serum ferritin levels were lower in patients receiving iron during follow up ( median 93 vs 251 ng/mL , p<0.001 ) . Iron supplementation was associated with a significantly reduced all-cause mortality [ HR ( 95%CI ) : 0.22 ( 0.08–0.58 ) ; p = 0.002 ] and a reduced cardiovascular and sepsis-related mortality [ HR ( 95%CI ) : 0.31 ( 0.09–1.04 ) ; p = 0.06 ] . Increasing ferritin concentrations in patients with normal CRP were associated with a decreasing mortality , whereas in patients with elevated CRP values ferritin levels>800 ng/mL were linked with increased mortality . Conclusions Iron supplementation is associated with reduced all-cause mortality in incident dialysis patients . While serum ferritin levels up to 800 ng/mL appear to be safe , higher ferritin levels are associated with increased mortality in the setting of concomitant inflammation
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 .