About one-third of ulcerative colitis patients with anemia are not tested for iron deficiency and nearly one-fourth of those diagnosed with iron deficiency anemia don’t receive iron replacement therapy, according to a new nationwide study.

Using data from the Veterans Affairs (VA) health care system from 2001 to 2011, researchers from the University Of Pennsylvania Perelman School Of Medicine identified 836 newly diagnosed ulcerative colitis patients. 

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Over a median of eight years follow-up 70% developed anemia, of these 31% did not undergo recommended testing for iron deficiency anemia. Among those tested, 63% were diagnosed with iron deficiency anemia, however almost a quarter of these patients (24%) did not receive iron replacement therapy.  

For severe anemia, intravenous iron supplementation is the preferred treatment, although the study findings showed that all patients received only oral iron supplements. In addition, patients were more likely to be treated if their anemia was severe versus mild (91% vs 55%, respectively). “This finding […] could explain the high prevalence of moderate to severe iron deficiency anemia in our population, as they were not treated during the early stage of their anemia,” Dr. Khan and the coauthors write.

The authors acknowledge that using the VA as a sole source limits their findings, however they conclude by stating that testing and treatment for iron deficiency should be added to the ulcerative colitis care quality indicators listed by the Crohn’s & Colitis Foundation of America and the American Gastroenterology Association.

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