Bertani Lorenzo, Tricò Domenico, Zanzi Federico, Baiano Svizzero Giovanni, Coppini Francesca, de Bortoli Nicola, Bellini Massimo, Antonioli Luca, Blandizzi Corrado, Marchi Santino
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56100 Pisa, Italy.
Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56100 Pisa, Italy.
Nutrients. 2021 Feb 12;13(2):608. doi: 10.3390/nu13020608.
Anemia is a frequent complication of ulcerative colitis, and is frequently caused by iron deficiency. Oral iron supplementation displays high rates of gastrointestinal adverse effects. However, the formulation of sucrosomial iron (SI) has shown higher tolerability. We performed a prospective study to compare the effectiveness and tolerability of oral SI and intravenous ferric carboxy-maltose (FCM) in patients with ulcerative colitis in remission and mild-to-moderate anemia. Patients were randomized 1:1 to receive 60 mg/day for 8 weeks and then 30 mg/day for 4 weeks of oral SI or intravenous 1000 mg of FCM at baseline. Hemoglobin and serum levels of iron and ferritin were assessed after 4, 8, and 12 weeks from baseline. Hemoglobin and serum iron increased in both groups after 4 weeks of therapy, and remained stable during follow up, without significant treatment or treatment-by-time interactions ( = 0.25 and = 0.46 for hemoglobin, respectively; = 0.25 and = 0.26 for iron, respectively). Serum ferritin did not increase over time during SI supplementation, while it increased in patients treated with FCM (treatment effect, = 0.0004; treatment-by-time interaction effect, = 0.0002). Overall, this study showed that SI and FCM displayed similar effectiveness and tolerability for treatment of mild-to-moderate anemia in patients with ulcerative colitis under remission.
贫血是溃疡性结肠炎常见的并发症，且常由缺铁引起。口服铁补充剂胃肠道不良反应发生率高。然而，蔗糖铁（SI）制剂显示出更高的耐受性。我们进行了一项前瞻性研究，比较口服SI和静脉注射羧基麦芽糖铁（FCM）对处于缓解期且有轻至中度贫血的溃疡性结肠炎患者的有效性和耐受性。患者按1:1随机分组，在基线时接受8周每天60毫克的口服SI，然后4周每天30毫克，或静脉注射1000毫克FCM。在基线后的4周、8周和12周评估血红蛋白以及铁和铁蛋白的血清水平。治疗4周后两组的血红蛋白和血清铁均升高，且在随访期间保持稳定，无显著的治疗或治疗-时间交互作用（血红蛋白分别为P = 0.25和P = 0.46；铁分别为P = 0.25和P = 0.26）。在补充SI期间血清铁蛋白未随时间增加，而在接受FCM治疗的患者中血清铁蛋白升高（治疗效应，P = 0.0004；治疗-时间交互效应，P = 0.0002）。总体而言，本研究表明，SI和FCM对处于缓解期的溃疡性结肠炎患者轻至中度贫血的治疗显示出相似的有效性和耐受性。
