Oxidative Stress and Inflammation Caused by Intravenous Iron in Crohn's Disease Patients With Iron Deficiency Anemia
Condition: Crohn's Disease
MeSH terms: Crohn Disease; Iron Deficiencies
Study type: Interventional

Summary: 
      Extra iron may not be necessary in the treatment of iron deficiency anemia in Crohn's
      Disease;Oxidative Stress and Inflammation may be Caused by Intravenous Iron in Crohn's
      Disease Patients With Iron Deficiency Anemia.
    

Detailed description: 
      Anemia is one of the commonest extra-intestinal manifestations of Crohn's disease (CD) with a
      prevalence ranging from 6.2% up to 73.7%.Compared with other complications,it has been
      subestimated and received less attention from gastroenterologists, although,which is
      frequently associated with a reduced quality of life.What's more,there were not appropriate
      strategies for the adequate treatment of anaemia in CD either.

      The anaemia in CD is caused by several factors, such as iron, folic acid or B12 deficiency,
      treatment with immunosuppressive drugs or sulfasalazine-induced hemolysis, and anemia of
      chronic disease, of which iron deficiency was one of the most important mechanisms.
      Additionally, erythropoietin(EPO) levels in chronic disease anemia are generally higher than
      in normal subjects.However, in CD anemic patients this EPO increase is inadequate in relation
      to the degree of anemia.Thus, in the treatment of iron deficiency anemia (IDA) in CD,EPO and
      iron supplementation are very common.Because intravenous(IV) iron is more effective and
      better tolerated than oral iron and is to be considered in patients with severe anemia
      (Hb<10.0 g/dL), with intolerance or inadequate response to oral iron and/or those with active
      IBD. Intravenous iron administration is the route of choice when simultaneous treatment with
      erythropoiesis stimulat-ing agents (ESA) is considered.

      But parenteral iron formulations have potential toxic effects such as triggering oxidative
      reactions and inflammatory reactions that may be very disadvantageous to CD patients. Free
      iron may provoke formation of free oxygen radicals. Although complex carbohydrate structures
      that cover free iron may alleviate this oxidative and inflammatory potential,it cannot be
      completely blocked. These suggest that parenteral iron could be a "double-edged sword" with
      the hematologic beneﬁts (increase in hemoglobin [Hb]) on the one hand, and with the risk of
      enhancement of systemic inﬂammation and oxidative stress on the other.

      Although the oxidative potential of intravenous iron (IVI) has been studied extensively,there
      have been no studies about the effects of parenteral iron therapy on oxidative stress and
      inflammatory markers in the CD population. In this study, we compared different types and
      schedules of iron compounds for their effects on serum inflammatory-oxidative stress indices.
    

Intervention name(s): erythropoietin; enteral nutrition.; injection of iron
Intervention type(s): Drug; Drug; Drug
Intervention MeSH terms: Epoetin Alfa
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Crohn's Disease; intravenous iron; iron deficiency anaemia; Oxidative Stress; inflammation