Background and Aims: 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 IBD-specific 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.