OBJECTIVES. To evaluate in real-world clinical practice the impact of iron-therapy supplementation in inflammatory bowel disease (IBD) patients with iron-deficiency anemia (IDA), in terms of IBD disease progression and healthcare-resource consumption.

METHODS. A retrospective study was conducted using Italian entities' administrative databases, covering around 9.3 million health-assisted individuals. Across 01/01/2010-30/09/2017, adult IBD patients [diagnosed by ≥1 hospitalization for ulcerative colitis and/or Crohn’ disease, and/or active exemption code, and/or one prescription for Vedolizumab] were enrolled. Among them, IDA patients were identified by ≥1 prescription for iron and/or other anemia treatments and/or IDA hospitalization and/or blood transfusion (proxy of diagnosis). IBD-IDA patients were divided in untreated and iron-treated during follow-up (12 months) and analyzed before and after the Propensity-Score-Matching (PSM) methodology. The IBD disease progression(as IBD-related hospitalizations and surgeries), healthcare-costs, healthcare-resource utilization [drugs, outpatient specialist services (OSS), and hospitalizations] were assessed during follow-up.

RESULTS. Overall, 1,753 IBD-IDA patients were enrolled and sub-grouped in untreated (N=676, mean age 58.5 years, male 43%) and iron-treated (N=1,077, mean age 54.5 years, 45% male). Post-PSM, 676 patients were included in each cohort (mean age 58 years), 43% and 42% male (untreated and treated-cohort, respectively). Pre-PSM, the percentage of iron-treated patients with IBD progression (11%) resulted to be significantly lower versus untreated patients (15.7%); in particular, the extent of IBD-related hospitalizations was significantly reduced among iron-treated versus untreated patients (10.5% vs 14.3%, respectively). Both pre- and post-PSM (same values observed), the average annual number of hospitalizations (0.5 vs. 0.6) and OSS (8.8 vs. 11.4) were significantly lower in treated versus untreated patients, respectively; in iron-treated versus untreated cohort, the overall average cost/patient (4,643€ vs. 6,391€; post-PSM: 4,686€ vs. 6,391€) was significantly reduced.

CONCLUSIONS. This real-world study shows that in IBD-IDA patients, iron-therapy supplementation could be associated with beneficial effects in terms of IBD disease progression, healthcare-resource utilization and economic burden.