Intravenous versus oral iron for the treatment of anemia in inflammatory bowel disease: a systematic review and meta-analysis of randomized controlled trials

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• dc.contributor.author Bonovas, Stefanos
• dc.contributor.author Fiorino, Gionata
• dc.contributor.author Allocca, Mariangela
• dc.contributor.author Lytras, Theodoros, 1987-
• dc.contributor.author Tsantes, Argirios
• dc.contributor.author Peyrin-Biroulet, Laurent
• dc.contributor.author Danese, Silvio
• dc.date.accessioned 2023-11-20T08:23:08Z
• dc.date.available 2023-11-20T08:23:08Z
• dc.date.issued 2016
• dc.description.abstract Anemia is the most prevalent extraintestinal complication of inflammatory bowel disease (IBD). Our aim was to evaluate the comparative efficacy and harm of intravenous (IV) versus oral iron supplementation for correcting anemia in adult IBD patients. We conducted a systematic review and meta-analysis to integrate evidence from randomized controlled trials having enrolled adults with IBD, and comparing IV versus oral iron (head-to-head) for correcting iron-deficiency anemia. Medline, Embase, Scopus, and the Web of Science database were searched through July 2015. The Cochrane Central Register of Controlled Trials, the WHO International Clinical Trials Registry Platform, the ClinicalTrials.gov, and international conference proceedings were also investigated. Two reviewers independently abstracted study data and outcomes, and rated each trial's risk-of-bias. Pooled odds ratio (OR) estimates with their 95% CIs were calculated using fixed- and random-effects models. Five eligible studies, including 694 IBD patients, were identified. In meta-analysis, IV iron demonstrated a higher efficacy in achieving a hemoglobin rise of ≥2.0 g/dL as compared to oral iron (OR: 1.57, 95% CI: 1.13, 2.18). Treatment discontinuation rates, due to adverse events or intolerance, were lower in the IV iron groups (OR: 0.27, 95% CI: 0.13, 0.59). Similarly, the occurrence of gastrointestinal adverse events was consistently lower in the IV iron groups. On the contrary, serious adverse events (SAEs) were more frequently reported among patients receiving IV iron preparations (OR: 4.57, 95% CI: 1.11, 18.8); however, the majority of the reported SAEs were judged as unrelated or unlikely to be related to the study medication. We found no evidence of publication bias, or between-study heterogeneity, across all analyses. Risk of bias was high across primary studies, because patients and personnel were not blinded to the intervention. IV iron appears to be more effective and better tolerated than oral iron for the treatment of IBD-associated anemia.
• dc.format.mimetype application/pdf
• dc.identifier.citation Bonovas S, Fiorino G, Allocca M, Lytras T, Tsantes A, Peyrin-Biroulet L, et al. Intravenous versus oral iron for the treatment of anemia in inflammatory bowel disease: a systematic review and meta-analysis of randomized controlled trials. Medicine. 2016 Jan;95(2):e2308. DOI: 10.1097/MD.0000000000002308
• dc.identifier.doi http://dx.doi.org/10.1097/MD.0000000000002308
• dc.identifier.issn 0025-7974
• dc.identifier.uri http://hdl.handle.net/10230/58304
• dc.language.iso eng
• dc.publisher Lippincott Williams & Wilkins
• dc.relation.ispartof Medicine. 2016 Jan;95(2):e2308
• dc.rights Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nd/4.0/
• dc.subject.other Anèmia
• dc.subject.other Anèmia ferropènica
• dc.subject.other Aparell digestiu -- Malalties
• dc.title Intravenous versus oral iron for the treatment of anemia in inflammatory bowel disease: a systematic review and meta-analysis of randomized controlled trials
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion