High-Dose IV Iron Safely and Effectively Treats IBD-Associated Anemia Regardless of Inflammatory Activity: Real-Life Evidence from Germany

A study involving 421 patients with Crohn’s disease or ulcerative colitis in Germany demonstrated that high-dose intravenous (IV) iron therapy is effective and safe for treating iron deficiency anaemia (IDA) associated with inflammatory bowel disease (IBD), regardless of inflammatory activity. Patients received either iron isomaltoside or ferric carboxymaltose, with a mean cumulative dose of approximately 1,200 mg over 12-16 weeks. Results showed significant improvements in haemoglobin levels, ferritin, and transferrin saturation, with a notable decrease in C-reactive protein (CRP) levels, especially in those with elevated baseline CRP. Clinical disease activity and IBD-related symptoms improved consistently, and no worsening of disease activity was observed. The study supports high-dose IV iron as a standard care for IBD-associated anaemia, highlighting its inflammation-neutral properties and positive impact on patient-reported symptoms.