Centre for Digestive Diseases, Blizard Institute of Cell and Molecular Science, Barts and London School of Medicine and Dentistry, London, UK.
Eur J Gastroenterol Hepatol. 2011 Nov;23(11):1029-35. doi: 10.1097/MEG.0b013e32834a58d1.
Iron deficiency anaemia is common in inflammatory bowel disease (IBD); however, the optimum route of administration of iron replacement therapy is unclear. As inflammation may limit the absorption and efficacy of oral iron, we hypothesized that in routine clinical practice IV iron would be more effective than oral iron in patients with IBD matched for disease type, extent and activity.
Thirty-three IBD patients who had received IV iron dextran (Cosmofer) in 2008-2010 were identified and matched for age, sex, diagnosis and baseline disease activity, extent and behaviour to IBD patients given oral iron.
Patients given IV iron dextran were more anaemic at baseline than those receiving oral iron. Although haemoglobin (Hb) concentrations were normalized in about a third of patients, and increased significantly in both groups, the mean increase in Hb after 8 weeks was greater in the iron dextran group [2.0 g/dl (0.3) vs. 0.6 g/dl (0.1), P<0.0001]. Response to oral or IV iron was unrelated to age, sex, ethnicity, disease duration, extent or activity. Fifteen percent (five out of 33) patients discontinued oral iron because of gastrointestinal side-effects and a further two out of 35 had anaphylactoid reactions to the IV iron dextran test doses. Neither of the iron formulations worsened disease activity.
In routine clinical practice, in anaemic patients with IBD of similar type, extent and activity, IV Cosmofer is more efficacious in increasing Hb concentration than oral iron. Active disease does not impair the response to either IV or oral iron in patients with IBD, and neither product itself worsens disease activity.
缺铁性贫血在炎症性肠病（IBD）中很常见；然而，铁替代治疗的最佳给药途径尚不清楚。由于炎症可能会限制口服铁的吸收和疗效，我们假设在常规临床实践中，对于疾病类型、程度和活动度相匹配的 IBD 患者，静脉铁（Cosmofer）比口服铁更有效。
确定了 2008-2010 年接受静脉注射右旋糖酐铁（Cosmofer）的 33 例 IBD 患者，并根据年龄、性别、诊断和基线疾病活动度、程度和行为与接受口服铁治疗的 IBD 患者进行匹配。
接受静脉注射右旋糖酐铁的患者在基线时比接受口服铁的患者更贫血。虽然大约三分之一的患者的血红蛋白（Hb）浓度正常化，并且两组的 Hb 浓度均显著增加，但铁右旋糖酐组 8 周后 Hb 的平均增加量更大[2.0 g/dl（0.3）比 0.6 g/dl（0.1），P<0.0001]。口服或静脉铁的反应与年龄、性别、种族、疾病持续时间、程度或活动度无关。15%（5/33）的患者因胃肠道副作用而停止口服铁治疗，另有 2/35 的患者对静脉注射铁右旋糖酐试验剂量出现过敏样反应。两种铁制剂均未加重疾病活动度。
在常规临床实践中，对于类型、程度和活动度相似的贫血性 IBD 患者，静脉注射 Cosmofer 比口服铁更能有效增加 Hb 浓度。活动性疾病不会损害 IBD 患者对静脉或口服铁的反应，并且两种制剂本身都不会加重疾病活动度。
