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Improvement of Health-Related Quality of Life in Children with Inflammatory Bowel Disease Receiving Routine
Insights
Correcting iron deficiency anemia (IDA) in children with inflammatory bowel disease (IBD) using intravenous iron sucrose (IVIS) improved health-related quality of life (HRQL). This long-term study shows a link between anemia correction and better emotional and physical well-being.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Quality of Life Research
Background:
- Iron deficiency anemia (IDA) is prevalent in pediatric inflammatory bowel disease (IBD).
- Health-related quality of life (HRQL) is crucial but understudied in this context.
- Long-term effects of IDA correction on HRQL in pediatric IBD are not well-established.
Purpose of the Study:
- To prospectively evaluate changes in HRQL in iron-deficient children with IBD.
- To assess the impact of routine iron supplementation with periodic intravenous iron sucrose (IVIS) on HRQL.
- To determine the correlation between hemoglobin normalization and HRQL improvements.
Main Methods:
- Thirty-eight pediatric IBD patients on infliximab were studied.
- Iron deficiency was defined by transferrin saturation and/or ferritin levels.
- Intravenous iron sucrose (IVIS) was administered post-infusion until iron indices normalized; HRQL was measured using the Pediatric Quality of Life Inventory.
Main Results:
- Mean iron indices and hemoglobin normalized within 3 and 6 months of IVIS initiation, respectively.
- Significant improvements were observed in multiple HRQL parameters.
- A positive correlation was found between anemia correction and enhanced parent-reported emotional and physical HRQL scores.
Conclusions:
- Periodic IVIS effectively achieved long-term correction of IDA in pediatric IBD patients.
- Correction of IDA positively contributed to improvements in children's HRQL.
Objectives:
Iron deficiency anemia (IDA) is very common in children with inflammatory bowel disease (IBD). While health-related quality of life (HRQL) is a key outcome measure, no long-term studies have evaluated the effect of correction of IDA on HRQL in children with IBD. Our goal was to prospectively study changes in HRQL in iron-deficient children with IBD receiving routine iron supplementation with periodic intravenous iron sucrose (IVIS).
Methods:
Thirty-eight children with IBD treated with infliximab participated. Hematology and inflammatory markers were assessed before each infliximab treatment. Iron-deficient patients (transferrin saturation below 20% and/or ferritin below 30 ng/mL or 100 ng/mL with normal or elevated C-reactive protein, respectively) received IVIS after each infliximab infusion until iron indices stayed normal for two consecutive measurements. HRQL was assessed with Pediatric Quality of Life Inventory every 4 months. Correlation between changes in mean hemoglobin levels and HRQL scores was analyzed prospectively in 3-month periods over a period exceeding 3 years.
Results:
At enrollment, 27 patients had already been established on infliximab; 11 had not started or completed induction. Mean iron indices and hemoglobin normalized after 3 and 6 month of starting IVIS, respectively. Multiple HRQL parameters significantly improved, regardless of the duration of infliximab treatment at the time of enrollment. There was a statistically significant positive correlation between correction of anemia and improvement in parent-reported emotional and physical HRQL scores.
Conclusions:
Periodic IVIS resulted in long-term correction of IDA in children with IBD. Correction of IDA contributed to some improvements in HRQL.
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