Natural history of anemia and efficacy and safety of oral iron therapy in children newly diagnosed with inflammatory bowel disease

Objectives: Anemia is one of the most common extraintestinal manifestations of pediatric inflammatory bowel disease (IBD). We aimed to evaluate the prevalence of anemia in children newly diagnosed with IBD and assess the efficacy and safety of oral iron therapy over a 12-month follow-up period. Methods: This single-center, retrospective, observational cohort study included all children newly diagnosed with IBD at the Pediatric Gastroenterology Unit of Sapienza University of Rome from May 2015 to May 2019 presenting with anemia. At baseline, demographic, clinical, laboratory data (hemoglobin, mean corpuscular volume, serum iron, ferritin, transferrin levels, erythrocyte sedimentation rate, and c-reactive protein), and treatment received, were recorded. Clinical and laboratory data, as well as anemia therapy and adverse events, were collected every three months during the 1-year follow-up. Results: Eighty-nine out of 140 patients newly diagnosed with IBD presented with anemia (64%), 13 were excluded due to incomplete follow-up, thus 76 were included [median age 12,7, (IQR 9.8-15), 25 (33%) Crohn's disease, 51 (67%) ulcerative colitis]. All patients received Sucrosomial Iron alone or in combination with intravenous ferric carboxymaltose. Treatment with SI was effective in 67 (88%) patients at the end of follow-up [37 (48%) within 3 months], regardless of anemia severity at baseline. No serious adverse events related to SI treatment were reported. Conclusions: We confirmed a high prevalence of anemia at the time of the diagnosis of pediatric IBD. Our data suggest that Sucrosomial Iron is safe and effective, leading to anemia resolution in approximately half of the patients within three months.