Iron deficiency is a common and undertreated problem in inflammatory bowel disease (IBD).
Professor Reinisch and colleagues from Austria developed an online tool to support treatment choice at the patient-specific level.
Using the RAND/UCLA Appropriateness Method (RUAM), a European expert panel assessed the appropriateness of treatment regimens for a variety of clinical scenarios in patients with non-anemic iron deficiency (NAID) and iron deficiency anemia.
Treatment options included adjustment of IBD medication only, oral iron supplementation, high-/low-dose intravenous regimens, IV iron plus erythropoietin-stimulating agent, and blood transfusion.
The panel process consisted of 2 individual rating rounds, and 3 plenary discussion meetings.
|For 98% of scenarios, at least 1 treatment was appropriate|
|Alimentary Pharmacology & Therapeutics|
The panel reached agreement on 71% of treatment indications.
The research team reported that ‘No treatment’ was never considered appropriate, and repeat treatment after previous failure was generally discouraged.
The team found that for 98% of scenarios, at least 1 treatment was appropriate.
Adjustment of IBD medication was deemed appropriate in all patients with active disease.
The team reported that use of oral iron was mainly considered an option in NAID and mildly anemic patients without disease activity.
IV regimens were often judged appropriate, with high-dose IV iron being the preferred option in 77% of iron deficiency anemia scenarios.
Blood transfusion and intravenous plus erythropoietin-stimulating agent were indicated in exceptional cases only.
Professor Reinisch's team concluded, "The RUAM revealed high agreement amongst experts on the management of iron deficiency in patients with IBD."
"High-dose IV iron was more often considered appropriate than other options."
"To facilitate dissemination of the recommendations, panel outcomes were embedded in an online tool, accessible via http://ferroscope.com/."