Prevalence, Pathogenesis and Management of Anemia in Inflammatory Bowel Disease: An IG-IBD Multicenter, Prospective, and Observational Study.


Journal

Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162

Informations de publication

Date de publication:
05 01 2023
Historique:
received: 13 12 2021
pubmed: 3 4 2022
medline: 11 1 2023
entrez: 2 4 2022
Statut: ppublish

Résumé

Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD), with a 6% to 74% prevalence and a negative impact on patient survival and quality of life, although the prevalence is apparently declining due to improved disease treatment. We aimed to investigate the prevalence, pathogenesis, and clinical correlates of anemia in Italian patients with IBD. A multicenter, prospective, observational study, involving 28 Italian gastroenterology centers, was conducted to investigate the epidemiology and consequences of IBD-associated anemia. Clinical and laboratory data of anemic patients were obtained at study enrolment. Anemia was diagnosed in 737 of 5416 adult IBD outpatients (prevalence 13.6%); females were more commonly affected than males (odds ratio, 1.5; 95% confidence interval [CI], 1.2-1.7) and had more severe anemia. In the majority of cases, anemia was due to iron deficiency (62.5% of cases; 95% CI, 58.3%-66.6%), either isolated or in association with inflammation and/or vitamin deficiencies; anemia of inflammation accounted for only 8.3% of cases. More severe anemia was associated with increasing fatigue and worse quality of life. Only 68.9% of anemic patients with iron deficiency (95% CI, 63.4%-73.8%) and 34.6% of those with vitamin deficiencies (95% CI, 26.2%-44.2%) were properly treated with supplementation therapy. In Italy, the prevalence of IBD-associated anemia is lower than previously reported. Anemia of IBD is most commonly due to iron deficiency and contributes to fatigue and poor quality of life, but remains untreated in a large proportion of patients with iron and/or vitamin deficiencies. This study is registered at clinicaltrials.gov as NCT02872376. The prevalence of inflammatory bowel disease–associated anemia is 13.6%. The prevalence is higher among females younger than 50. Anemia is usually due to iron deficiency and adversely affects fatigue and quality of life. Many patients with iron or vitamin deficiency (31% and 65%, respectively) remain untreated.

Sections du résumé

BACKGROUND
Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD), with a 6% to 74% prevalence and a negative impact on patient survival and quality of life, although the prevalence is apparently declining due to improved disease treatment. We aimed to investigate the prevalence, pathogenesis, and clinical correlates of anemia in Italian patients with IBD.
METHODS
A multicenter, prospective, observational study, involving 28 Italian gastroenterology centers, was conducted to investigate the epidemiology and consequences of IBD-associated anemia. Clinical and laboratory data of anemic patients were obtained at study enrolment.
RESULTS
Anemia was diagnosed in 737 of 5416 adult IBD outpatients (prevalence 13.6%); females were more commonly affected than males (odds ratio, 1.5; 95% confidence interval [CI], 1.2-1.7) and had more severe anemia. In the majority of cases, anemia was due to iron deficiency (62.5% of cases; 95% CI, 58.3%-66.6%), either isolated or in association with inflammation and/or vitamin deficiencies; anemia of inflammation accounted for only 8.3% of cases. More severe anemia was associated with increasing fatigue and worse quality of life. Only 68.9% of anemic patients with iron deficiency (95% CI, 63.4%-73.8%) and 34.6% of those with vitamin deficiencies (95% CI, 26.2%-44.2%) were properly treated with supplementation therapy.
CONCLUSIONS
In Italy, the prevalence of IBD-associated anemia is lower than previously reported. Anemia of IBD is most commonly due to iron deficiency and contributes to fatigue and poor quality of life, but remains untreated in a large proportion of patients with iron and/or vitamin deficiencies. This study is registered at clinicaltrials.gov as NCT02872376.
The prevalence of inflammatory bowel disease–associated anemia is 13.6%. The prevalence is higher among females younger than 50. Anemia is usually due to iron deficiency and adversely affects fatigue and quality of life. Many patients with iron or vitamin deficiency (31% and 65%, respectively) remain untreated.

Autres résumés

Type: plain-language-summary (eng)
The prevalence of inflammatory bowel disease–associated anemia is 13.6%. The prevalence is higher among females younger than 50. Anemia is usually due to iron deficiency and adversely affects fatigue and quality of life. Many patients with iron or vitamin deficiency (31% and 65%, respectively) remain untreated.

Identifiants

pubmed: 35366312
pii: 6562695
doi: 10.1093/ibd/izac054
doi:

Banques de données

ClinicalTrials.gov
['NCT02872376']

Types de publication

Observational Study Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

76-84

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. 
For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Gaetano Bergamaschi (G)

Medicina Generale I, Fondazione stituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo e Università di Pavia, Pavia, Italy.

Fabiana Castiglione (F)

Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.

Renata D'Incà (R)

Inflammatory Bowel Disease Unit-Azienda Ospedaliera-University of Padua, Padua, Italy.

Marco Astegiano (M)

Gastroenterology and Digestive Endoscopy Unit, "Città della Salute e della Scienza" Hospital, Torino, Italy.

Walter Fries (W)

Gastroenterology and Clinical Unit for Inflammatory Bowel Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Monica Milla (M)

Unità Operativa Complessa di Gastroenterologia Cinica, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.

Carolina Ciacci (C)

Gastroenterology and Endoscopy Unit, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona and University of Salerno, Salerno, Italy.

Fernando Rizzello (F)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Simone Saibeni (S)

Gastroenterology Unit, Rho Hospital, Azienda Socio-Sanitaria Territoriale Rhodense, Rho (MI), Italy.

Rachele Ciccocioppo (R)

Unità Operativa Complessa Gastroenterologia B, Azienda Ospedaliera Universitaria Integrata Policlinico G.B. Rossi & Dipartimento di Medicina, Università di Verona, Verona, Italy.

Ambrogio Orlando (A)

Inflammatory Bowel Disease Unit, Azienda Ospedaliera Ospedali Riuniti "Villa Sofia-Cervello" Palermo, Palermo, Italy.

Fabrizio Bossa (F)

Department of Gastroenterology and Endoscopy, Fondazione "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, Italy.

Mariabeatrice Principi (M)

Gastroenterology Unit (Department of Emergency and Organ transplantation), University of Bari, Bari, Italy.

Piero Vernia (P)

Division of Gastroenterology, Department of Translational and Precision Medicine, "Sapienza" University of Rome and Umberto I Hospital, Rome, Italy.

Chiara Ricci (C)

Gastroenterology Unit, Spedali Civili di Brescia and Department of Clinical and Sperimental Sciences, University of Brescia, Brescia, Italy.

Maria L Scribano (ML)

Gastroenterology and Endoscopy Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.

Giorgia Bodini (G)

Gastroenterology Unit, Department of Internal Medicine, Policlinico San Martino, Università di Genova, Genoa, Italy.

Dario Mazzucco (D)

Gastroenterology Unit, ASL Torino 3, Rivoli, Torino, Italy.

Gabrio Bassotti (G)

Gastroenterology & Hepatology Unit, Perugia General Hospital and University of Perugia, Perugia, Italy.

Gabriele Riegler (G)

Unit of Gastroenterology-Reference Center for IBD-Second University of Naples, Naples, Italy.

Andrea Buda (A)

Unità Operativa Complessa Gastroenterologia, Ospedale S. Maria del Prato, Azienda - Unità Locale Socio Sanitaria 1 Dolomiti, Feltre, Italy.

Matteo Neri (M)

Department of Medicine and Ageing Sciences and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy.

Flavio Caprioli (F)

Gastroenterology and Endoscopy Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy.

Fabio Monica (F)

Gastroenterology and Digestive Endoscopy Unit, Azienda sanitaria universitaria Giuliano Isontina, Cattinara Academic Hospital, Trieste, Italy.

Aldo Manca (A)

Department of Gastroenterology and Digestive Endoscopy, S. Croce e Carle Hospital, Cuneo, Italy.

Erica Villa (E)

UC Gastroenterologia, Dipartimento di Specialità Mediche, Azienda Ospedaliera Universitaria di Modena, Modena, Italy.

Gionata Fiorino (G)

Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital, Rozzano, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Michele Comberlato (M)

Gastroenterologia, Fisiopatologia ed Endoscopia Digestiva, Azienda Sanitaria dell'Alto Adige, Bolzano, Italy.

Nicola Aronico (N)

Medicina Generale I, Fondazione stituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo e Università di Pavia, Pavia, Italy.

Cristina Della Corte (C)

Gastroenterology Unit, Rho Hospital, Azienda Socio-Sanitaria Territoriale Rhodense, Rho (MI), Italy.

Roberta Caccaro (R)

Inflammatory Bowel Disease Unit-Azienda Ospedaliera-University of Padua, Padua, Italy.

Paolo Gionchetti (P)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Paolo Giuffrida (P)

Medicina Generale I, Fondazione stituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo e Università di Pavia, Pavia, Italy.

Paola Iovino (P)

Gastroenterology and Endoscopy Unit, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona and University of Salerno, Salerno, Italy.

Marco V Lenti (MV)

Medicina Generale I, Fondazione stituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo e Università di Pavia, Pavia, Italy.

Caterina Mengoli (C)

Medicina Generale I, Fondazione stituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo e Università di Pavia, Pavia, Italy.

Lucienne Pellegrini (L)

Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.

Alberto Pieraccini (A)

Unità Operativa Complessa di Gastroenterologia Cinica, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.

Davide Ribaldone (D)

Gastroenterology and Digestive Endoscopy Unit, "Città della Salute e della Scienza" Hospital, Torino, Italy.

Anna Testa (A)

Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.

Cristina Ubezio (C)

Medicina Generale I, Fondazione stituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo e Università di Pavia, Pavia, Italy.

Anna Viola (A)

Gastroenterology and Clinical Unit for Inflammatory Bowel Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Maurizio Vecchi (M)

Gastroenterology and Endoscopy Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy.

Catherine Klersy (C)

Servizio di Epidemiologia Clinica & Biometria, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Antonio Di Sabatino (A)

Medicina Generale I, Fondazione stituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo e Università di Pavia, Pavia, Italy.

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