The Efficiency of Intravenous Iron Therapy in Korean Inflammatory Bowel Disease Patients

Inflammatory bowel disease (IBD) is associated with chronic intestinal inflammation, complications, and variable extraint-estinal manifestations. 1-3 Although anemia is one of the most common extraintestinal manifestations and can affect quality of life in patients with IBD, it's clinical importance has been underestimated. However, in a recently issued Western guideline, which placed focused on the morbidity associated with anemia, regular assessment and appropriate management, such as, intravenous iron supplementation, were recommended. 4 Iron deficiency anemia (IDA) is the most common cause of anemia with reported prevalence of 30% to 90% in IBD patients and iron supplementation should be initiated in addition to control disease, as soon as iron deficiency is detected. To correct IDA, iron supplementation, erythropoietin administration , and red blood cell transfusions could be considered. 6 Iron may be administered via two routes, that is, orally or by intravenous supplementation, although some disagreement exists regarding the efficacy and safety of these routes. Oral iron is equivalent to and cheaper than intravenous iron, but oral iron has a limitation of gut absorption and nonabsorbed iron can be toxic in the presence of mucosal inflammation and aggravate disease. 8 Furthermore, oral iron is associated with slow response and intolerance. 9 Intravenous iron, on the other hand, is better tolerated and more effective at normalizing hemoglobin and ferritin levels in the short term, though this is dependent on he-moglobin level and body weight. 9 Based on published information , international guidelines have been issued to the effect that intravenous administration is preferred. 4,9 However, physicians are reluctant to use intravenous iron because of its rare and fatal side effect. 9 However, nowadays, new effective, safe preparations are available. 6 Much of the data concerning these issues has resulted from Western studies. In that point, the study performed by Han et al. 10 has clinical significance for the management of Asian IBD patients with IDA. This comparative observational study was undertaken to assess and compare the efficacies of parenteral and oral iron therapy in Korean IBD patients. The most common indication for parenteral iron therapy was intolerance to oral iron therapy, which had a prevalence of 24%, followed by severe anemia and disease or nonresponsiveness to oral iron in 22%. Furthermore, these findings were consistent with those of a previous study except the starting level of hemoglobin, in which it was suggested that intravenous iron should be considered in cases with active disease, …