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A Shift From Oral to Intravenous Iron Supplementation Therapy Is Observed Over Time in a Large Swiss Cohort of Patients With Inflammatory Bowel Disease

Vavricka, Stephan R. MD*,†; Schoepfer, Alain M. MD; Safroneeva, Ekaterina PhD§; Rogler, Gerhard MD, PhD*; Schwenkglenks, Matthias PhD, MPH; Achermann, Rita MSc

doi: 10.1097/MIB.0b013e31827febbb
Original Clinical Articles

Background: In 2007, leading international experts in the field of inflammatory bowel disease (IBD) recommended intravenous (IV) iron supplements over oral (PO) ones because of superior effectiveness and better tolerance. We aimed to determine the percentage of patients with IBD undergoing iron therapy and to assess the dynamics of iron prescription habits (IV versus PO).

Methods: We analyzed anonymized data on patients with Crohn’s disease and ulcerative colitis extracted from the Helsana database. Helsana is a Swiss health insurance company providing coverage for 18% of the Swiss population (1.2 million individuals).

Results: In total, 629 patients with Crohn’s disease (61% female) and 398 patients with ulcerative colitis (57% female) were identified; mean observation time was 31.8 months for Crohn’s disease and 31.0 months for ulcerative colitis patients. Of all patients with IBD, 27.1% were prescribed iron (21.1% in males; 31.1% in females). Patients treated with steroids, immunomodulators, and/or anti–tumor necrosis factor drugs were more frequently treated with iron supplements when compared with those not treated with any medications (35.0% versus 20.9%, odds ratio, 1.94; P < 0.001). The frequency of IV iron prescriptions increased significantly from 2006 to 2009 for both genders (males: from 2.6% to 10.1%, odds ratio = 3.84, P < 0.001; females: from 5.3% to 12.1%, odds ratio = 2.26, P = 0.002), whereas the percentage of PO iron prescriptions did not change.

Conclusions: Twenty-seven percent of patients with IBD were treated with iron supplements. Iron supplements administered IV were prescribed more frequently over time. These prescription habits are consistent with the implementation of guidelines on the management of iron deficiency in IBD.

Article first published online 20 February 2013

*Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland

Division of Gastroenterology and Hepatology, Stadtspital Triemli, Zurich, Zurich, Switzerland

Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

§Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland

Helsana Health Insurance, Zurich, Switzerland.

Reprints: Stephan R. Vavricka, MD, Division of Gastroenterology and Hepatology, Stadtspital Triemli, 8063 Zurich, Switzerland (e-mail:

S. R. Vavricka and A. M. Schoepfer have contributed equally to the study.

This research was supported by grants from the Swiss National Science Foundation to S. R. Vavricka (320000-114009/3 and 32473B_135694/1) to G. Rogler (310030-120312) to A. M. Schoepfer (32003B_135665/1) and from the Swiss IBD Cohort (3347CO-108792), an educational grant from Vifor Pharma Ltd and by the Zurich Center for Integrative Human Physiology of the University of Zurich (S.R.V. and G.R.).

The authors declare that there is no conflict of interest, except for Dr. Matthias Schwenkglenks, whose research has been funded by Vifor Pharma Ltd.

The results presented in this publication are those of an investigator-initiated study. No pharmaceutical company had any role in study design, data collection, analysis, interpretation, or writing of this report.

Received June 07, 2012

Accepted June 25, 2012

© Crohn's & Colitis Foundation of America, Inc.
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