A randomized, controlled, multicenter study comparing intravenous iron sucrose versus oral iron supplementation for the treatment of iron deficiency anemia in patients with inflammatory bowel disease

Anemia is a frequent complication in patients with inflammatory bowel disease (IBD). The optimal route for iron supplementation has not been determined so far. We evaluated the efficacy and safety of intravenous iron sucrose as compared with oral iron sulfate for the treatment of iron deficiency anemia in IBD. A randomized, prospective, open-label, multicenter study was performed in 46 patients with anemia and a transferrin saturation ≤ 20% or serum ferritin concentrations ≤ 20µg/L. The intravenous group received a single dose of iron sucrose of 7mg iron per kg body weight, followed by subsequent 200mg infusions for the following five weeks. The oral group received iron sulfate 100–200mg/d for six weeks. While a comparable increase in hemoglobin was observed for both study drugs (9.6±1.2g/dL to 11.8±1.2g/dL in the intravenous group vs. 9.6±0.8g/dL to 11.9±1.2g/dL in the oral group), only iron sucrose led to a rise in serum ferritin concentrations. Intractable gastrointestinal adverse events lead to a permanent study drug discontinuation in 5/22 patients (20.8%) receiving iron sulfate, whereas only 1/24 patients (4.5%) had to be withdrawn because of side effects related to iron sucrose. Although being equal in short-term efficacy iron sucrose appears to be the treatment of choice for the treatment of iron deficiency anemia in inflammatory bowel disease due to its effective restoration of iron stores and better safety profile.