Inflammatory Bowel Diseases

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Inflammatory Bowel Diseases:
doi: 10.1097/01.MIB.0000442728.74340.fd
Clinical Review Articles

Prevalence of Anemia in Inflammatory Bowel Diseases in European Countries: A Systematic Review and Individual Patient Data Meta-analysis

Filmann, Natalie Dipl Math*; Rey, Julia Dipl Math*; Schneeweiss, Sven MD; Ardizzone, Sandro MD; Bager, Palle MPH§; Bergamaschi, Gaetano MD; Koutroubakis, Ioannis MD; Lindgren, Stefan MD, PhD**; Morena, Felipe de la MD††; Moum, Bjørn MD‡‡; Vavricka, Stephan R. MD§§; Schröder, Oliver MD; Herrmann, Eva PhD*; Blumenstein, Irina MD

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Background: The main objective is to determine the overall prevalence of anemia in inflammatory bowel diseases (IBD) in Europe.

Methods: A systematic literature search in PubMed and Embase was performed for studies published between January 2007 and May 2012. Eligible studies were included if they were original full-paper publications originated from Europe and if the authors agreed to provide their data. An overall prevalence of anemia in IBD, disease specific, and age–gender stratified basis prevalences were estimated. The influence of disease entity (Crohn's disease/ulcerative colitis), gender, age, disease activity (remission/active disease), and IBD-specific treatment strategies on the prevalence of anemia was analyzed by a mixed logistic regression model. Thereby, the factor country of origin was included as a random effect.

Results: Data were available for 2192 patients, mainly treated in tertiary referral centers. The overall prevalence of anemia in IBD patients was 24% (95% confidence interval, 18–31). Age–gender stratified prevalences were estimated for the age strata 18 to 29, 30 to 39, 40 to 49, 50 to 64, 65 to 74, >74 years and ranged from 18% to 35%. Patients receiving IBD-specific medication (P = 0.0002, odds ratio 1.54), and patients with active disease status (P < 0.0001, odds ratio 2.72) were significantly more likely to have anemia compared with patients not receiving IBD-specific medication or being in remission. Patients with ulcerative colitis tended to have anemia less likely than patients with Crohn's disease (P = 0.01, odds ratio 0.77).

Conclusions: The overall prevalence of anemia in patients with Crohn's disease was 27% (95% confidence interval, 19–35) and 21% (95% confidence interval, 15–27) in patients with ulcerative colitis. Thereby, 57% of the anemic patients were iron deficient.

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

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