IBD and Anemia: Adverse Events After IV Iron Therapy Examined

Only 1.3% of IBD patients ever developed any adverse event
Only 1.3% of IBD patients ever developed any adverse event

Among inflammatory bowel disease (IBD) patients with anemia, the incidence of adverse reactions after intravenous iron infusion appears to be low, according to research published in the journal Inflammatory Bowel Diseases.

To examine the occurrence of adverse reactions in this patient population, researchers from Johns Hopkins University, Baltimore, Maryland, conducted a retrospective analysis of IBD patients who received IV iron infusions between 2010 and 2014 in the commercial claims database, MarketScan. Patients with ≥2 IBD diagnosis codes who had an IV iron infusion and 7 days of follow-up were included.

The researchers specifically examined adverse events (AE) of anaphylactic shock, bronchospasm, and hypotension among IBD patients receiving ferumoxytol, iron dextran, ferric gluconate, iron sucrose, and ferric carboxymaltose. 

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A total of 6151 IBD patients (38.4% with ulcerative colitis; 61.6% with Crohn's disease) were given 37,168 IV iron infusions (median of 3 infusions) during the study period. Results showed that within the study group, only 1.3% of patients experienced an adverse reaction. Hypotension was the most common AE (2.04 per 1000 infusions); there were 0.24 anaphylactic shock events and 0.19 bronchospasm events per 1000 infusions.

The incidence of adverse events per 1000 infusions was highest among those receiving ferumoxytol (2.54, 95% CI, 1.26–5.11), ferric gluconate (1.85; 95% CI, 1.03–3.35), iron sucrose (1.74; 95% CI, 1.09–2.78), and iron dextran (0.96; 95% CI, 0.43–2.13). Same day IV iron infusion and IBD biologic administration was found to be safe. 

"Because adverse reactions are rare, physicians should be encouraged to adhere to recommended guidelines for iron replacement among anemic IBD patients," the authors concluded.

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