Background: The 2007 European Crohn's and Colitis Organization
guidelines on anemia in inflammatory bowel disease (IBD)
favour intravenous (iv) over oral (po) iron supplementation due
to better effectiveness and tolerance. We aimed to determine
the percentage of IBD patients under iron supplementation
therapy and the dynamics of prescription habits (iv versus po)
over time.
Methods: Helsana, a leading Swiss health insurance company
provides coverage for approximately 18% of the Swiss
population, corresponding to about 1.2 million enrollees.
Patients with Crohn's disease (CD) and ulcerative colitis (UC)
were analyzed from the anonymised Helsana database.
Results: In total, 629 CD (61% female) and 398 UC (57%
female) patients were identified, mean observation time was
31.8 months for CD and 31.0 months for UC patients. Of the
entire study population, 27.1% were prescribed iron (21.1%
in males and 31.1% in females). Patients treated with IBDspecific
drugs (steroids, immunomodulators, anti-TNF agents)
were more frequently treated with iron compared to patients
without any medication (35.0% vs. 20.9%, OR 1.91, 95%-
CI 1.41 2.61). The prescription of iv iron increased from
2006/2007 (48.8% of all patients receiving any iron priscription)
to 65.2% in 2008/2009 by a factor of 1.89.
Conclusions: One third of the IBD population was treated
with iron supplementation. A gradual shift from oral to iv iron
was observed over time. This switch in prescription habits
goes along with the implementation of the ECCO consensus
guidelines on anemia in IBD.