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Anemia in a population-based IBD cohort (ICURE): still high prevalence after 1 year, especially among pediatric
Daniel Sjöberg1, Tommy Holmström, Märit Larsson
1*Department of Internal Medicine, Falu Hospital, Falun, Sweden; †Department of Internal Medicine, Åland Central Hospital, Åland, Finland; ‡Department of Internal Medicine, Mälar Hospital, Eskilstuna, Sweden; and Departments of §Pediatrics, and ‖Medical Sciences, Uppsala University, Uppsala, Sweden.
Insights
Anemia is common in newly diagnosed inflammatory bowel disease (IBD) patients, affecting 30% at diagnosis and 18% after one year. Children with IBD face higher anemia risks, indicating a need for improved treatment strategies.
Area of Science:
- Gastroenterology
- Hematology
- Internal Medicine
Background:
- Anemia prevalence in inflammatory bowel disease (IBD) is not well-established due to limited population-based data.
- This study aimed to determine anemia prevalence in a population-based cohort of newly diagnosed IBD patients.
Purpose of the Study:
- Evaluate anemia prevalence at diagnosis and after one year in newly diagnosed IBD patients.
- Identify risk factors associated with anemia in IBD.
- Describe anemia-specific treatments administered within the first year of diagnosis.
Main Methods:
- Included 790 patients from the IBD Cohort of Uppsala Region diagnosed with ulcerative colitis or Crohn's disease.
- Utilized the World Health Organization (WHO) definition of anemia.
- Assessed hemoglobin levels at diagnosis and 12-month follow-up for 749 patients.
Main Results:
- Anemia prevalence was 30% at diagnosis (227/749) and 18% after one year (102/580).
- Crohn's disease patients had higher initial anemia rates (42%) than ulcerative colitis (24%), with no difference after one year.
- Children experienced higher anemia rates than adults at both diagnosis (55% vs. 27%) and follow-up (28% vs. 16%).
- Anemia correlated with colonic involvement in Crohn's disease and inflammation extent in ulcerative colitis.
- Only 46% of anemic patients received iron supplementation or blood transfusion.
Conclusions:
- High prevalence of anemia at IBD diagnosis, with a significant portion remaining anemic after one year.
- Children represent a higher-risk group for anemia compared to adults.
- Increased efforts are required for effective anemia management in IBD patients.
Background:
Prevalence of anemia in patients with inflammatory bowel disease (IBD) is uncertain because of scarcity of population-based studies. The aim of this study was to evaluate prevalence of anemia in a population-based cohort of newly diagnosed patients with IBD to identify risk factors for anemia and to describe contemporary anemia-specific treatment during the first year.
Methods:
All patients with ulcerative colitis or Crohn's disease in the IBD Cohort of Uppsala Region cohort (n = 790) and hemoglobin levels at the time of diagnosis were eligible for inclusion. The WHO definition of anemia was used.
Results:
Seven hundred forty-nine (95%) of the patients with IBD were included. Five hundred eighty of 749 (77%) patients had measured hemoglobin levels at 12-month follow-up. The prevalence of anemia at the time of diagnosis was 227/749 (30%). After 1 year, it was 102/580 (18%). Anemia was more common among newly diagnosed patients with Crohn's disease compared with ulcerative colitis (42% versus 24%, P < 0.0001), but after 1 year, there was no difference (18% versus 18%, P = NS). Children had more often anemia compared with adults, both at diagnosis and after 1 year (diagnosis: 55% versus 27%, P < 0.0001; follow-up: 28% versus 16%, P < 0.05). Anemia was associated with colonic engagement in Crohn's disease and the extent of inflammation in ulcerative colitis. Only 46% of patients with anemia were treated with iron supplementation or blood transfusion.
Conclusions:
The overall prevalence of anemia in patients with IBD at the time of diagnosis was high. A large proportion was still anemic after 1 year. Children were more at risk compared with adults. More efforts are needed to treat patients with anemia.
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