Anemia is common in inflammatory bowel disease (IBD). However, epidemiological studies of nonwestern IBD populations are limited and may be confounded by demographic, socioeconomic, and disease-related influences. This study evaluated the prevalence, risk factors, and etiology of anemia in Brazilian outpatients with IBD. Methods. In this cross-sectional study, 100 Crohn's disease (CD) patients and 100 ulcerative colitis (UC) subjects were assessed. Anemia workup included complete blood count, ferritin, transferrin saturation, serum levels of folic acid and vitamin B12, and C-reactive protein (CRP) concentration. Results. The overall prevalence of anemia in IBD was 21%. There was no significant difference in the prevalence of anemia between CD subjects (24%) and UC (18%). Moderate disease activity (OR: 3.48, 95% CI, 1.95–9.64, P = 0.002) and elevated CRP levels (OR: 1.8, 95% CI, 1.04–3.11, P = 0.02) were independently associated with anemia. The most common etiologies of anemia found in both groups were iron deficiency anemia (IDA; 10% on CD and 6% on UC) followed by the anemia of chronic disease (ACD; 6% for both groups). Conclusions. In Brazilian IBD outpatients, anemia is highly concurrent condition. Disease moderate activity as well as increased CRP was strongly associated with comorbid anemia. IDA and/or ACD were the most common etiologies.

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INTRODUCTION: Anemia is a common complication in inflammatory disease bowel (IBD). Many patients have this comorbidity ignored during clinical follow-up. Nonetheless, studies of anemic patients have a significant relationship between anemia and low quality of life. This study evaluated the quality of life before and after treatment for anemia in mild anemic, IBD patients from the IBD Center of the UFJF University Hospital. OBJECTIVE: The objective of the present study was to investigate the improvement of quality of life after treatment of anemia in IBD patients. METHODS: In this cross-sectional study, 100 patients with CD (Crohn's disease) and 100 with RCUI (ulcerative colitis) were screened for anemia. For evaluation of anemia, complete blood count, ferritin, saturation index transferrin, serum levels of folic acid, serum iron and vitamin B12 was performed. In anemic patients, was evaluated and compared the levels of quality of life before and after anemia treatment. For the evaluation of quality of life, the disease-specific quality of life (QOL) was acessed. RESULTS: The baseline IBDQ score for the cohort was 157 (±37) with a mean increase in the score by 26.4 (P <0.001) at week 8 compared to the baseline. CONCLUSION: Treatment with oral liposomal iron was effective in improving the treatment of anemia in IBD Brazilian outpatients showed statistically significant improvement in quality of life of patients with inactive or mildly active IBD.

BACKGROUND: Iron deficiency anemia (IDA) is one of the most common inflammatory bowel disease (IBD) complications. Importantly, anemia can contribute to patients’ poor quality of life, mainly because of its negative impact on the patients’ wellbeing, physical performance, mood, and cognitive function. In addition, anemia is a significant predictor of increased hospitalization risk, as well as of increased mortality in IBD patients. To the best of our knowledge, there are no published data concerning the use of oral liposomal iron to treat IDA in IBD patients. Therefore, the current study was a pilot study to assess the efficacy and safety of the oral liposomal iron in to treat mild IDA in patients with IBD, as well as to assess the impact of this treatment on psychometric scores. METHODS: Patients with inactive or mildly active IBD were screened for anemia in this interventional study conducted from November 2016 to March 2018. Patients with mild anemia were treated with oral liposomal iron for 8 weeks. The oral iron replenishment was provided to the patients on a compassionate use basis at the dose of two liposomal iron tablets per day (equivalent to 28 mg of liposomal iron). The primary endpoint of the study was the response rate to liposomal oral iron therapy. Treatment responders were defined as patients who achieved hemoglobin (Hb) increase of at least; 1 g/dL and/or Hb normalization by the 8th treatment week. The secondary endpoints included changes in ferritin concentration and transferrin saturation index (TSI) percentage from the baseline to the 8th week; impacts of the oral iron treatment on quality of life, and fatigue; changes in disease activity (assessed by HBI, Truelove and Witt’s criteria, and C-reactive protein - CRP); and treatment safety and tolerability. RESULTS: Of the 200 patients screened, 33 (16.5%) patients had anemia. Of the 21 patients who completed treatment, 13 (62%) responded to oral liposomal iron replacement therapy (mean increases of Hb 11.4 to 12.6 g/dL). The transferrin saturation index (TSI) increased by an average of 10.2 (P = 0.006) and the quality of life 26.3 (P 0.0001), despite no significant difference in baseline ferritin values. There was also a mean reduction of 9.2 in the perception of fatigue (P 0.0001). There was a linear correlation between the increase in Hb levels and the improvement of quality of life as evaluated by IBDQ (r = 0.54; P = 0.01). Following oral liposomal iron therapy, no change was seen in clinical disease activity (P = 0.10). In addition, CRP remains unchanged after treatment (P = 0.98). CONCLUSION(S): Treatment of IBD patients with oral liposomal iron was effective in improving anemia and quality of life, as well as in decreasing fatigue. This pilot study provides actual data supporting the therapeutic use of liposomal iron for treating mild IDA in IBD and paves the way for future studies evolving larger IBD populations utilizing higher doses of this drug and longer follow-up, to confirm the role of oral liposomal iron in treating quiescent or mildly active IBD patients presenting mild IDA.*This study is partially supported by the FAPEMIG-Brazil.

INTRODUCTION: Anemia is a common complication in inflammatory disease bowel (IBD). Many patients have this comorbidity ignored during clinical follow-up. Nonetheless, studies of anemic patients have a significant relationship between anemia and higher anxiety, depression and fatigue. This study evaluated the level of anxiety, depression and fatigue before and after treatment for anemia in mild anemic, IBD patients from the IBD Center of the UFJF University Hospital. OBJECTIVE: The objective of the present study was to investigate the improvement of anxiety, depression and fatigue after treatment of anemia in IBD patients. METHODS: In this cross-sectional study, 100 patients with CD (Crohn's disease) and 100 with RCUI (ulcerative colitis) were screened for anemia. For evaluation of anemia, complete blood count, ferritin, saturation index transferrin, serum levels of folic acid, serum iron and vitamin B12 was performed. In anemic patients, was evaluated and compared the levels of anxiety, depression and fatigue before and after anemia treatment. For the evaluation of anxiety was applied the hospital anxiety and depression scale (HADS), to assess fatigue was applied Chalder`s questionnaire. RESULTS: The evaluation average for anxiety before anemia treatment was 7.3 ± 4.3 and after treatment it was 5.3 ± 4.8 (p=0.0.08), the average of depression before treatment was 6.2 ± 5.2 and after treatment it was 4.9 ± 4.8 (p=0.08) and the average of fatigue before anemia treatment was 30.9 ± 8.7 and after treatment it was 21.6 ± 8.4 (p<0.001). Treatment with oral liposomal iron was effective in improving mild IDA and quality of life, as well as in decreasing fatigue in patients with inactive or mildly active IBD. CONCLUSION: The treatment of anemia in patients with IBD Brazilian outpatients showed statistically significant improvement in cases of anxiety and fatigue, although did not demonstrate a significant improvement in depression.