The use of oral iron in iron deficiency (ID) and ID anemia (IDA) in inflammatory bowel disease (IBD) is controversial. Its lower cost and ease of administration must be weighed against side effects and efficacy. The aim of this study was to compare the efficacy and tolerability of two oral iron formulations (Sucrosomial® iron [SI] and ferric hydroxide-polymaltose complex [FHPC] for correcting ID and IDA in IBD. As a secondary objective, we aimed to assess the impact of oral iron on correcting ID, IDA, and disability in IBD. This was a prospective, observational, bicentric cohort study. We included patients with IBD diagnosed with ID or IDA between November 2022 and November 2023. Physicians were preassigned by the investigators to prescribe SI or FHPC. The primary outcome was the efficacy of treatment with oral iron (Hb increase ≥2 g/dL and/or normalization of Hb levels in patients with IDA or correction of iron parameters in patients with ID alone) by week 12. The secondary outcomes were tolerability and the impact of oral iron on the quality of life and disability (IBD-Disk). A total of 56 patients were included in this study (FHPC group, 33; SI group, 23). A total of 47 patients had ID alone and 9 had IDA. There was no difference in the efficacy between the two formulations. After 12 weeks, 22% of the patients had an increase in Hb ≥2 g/dL and/or normalization of Hb levels or iron parameters. There was an improvement in serum iron (53.5 [45] vs. 64.5 [73]; p = 0.017), transferrin saturation index (17.0 [10] vs. 26.0 [13]; p < 0.001), and Hb levels (in patients with IDA) (11.9 ± 0.9 vs. 12.5 ± 1.2; p = 0.041). The IBD-Disk scores improved (p = 0.004) after treatment, and this improvement correlated with increased serum iron (rs = -0.43; p = 0.010) and Hb (rs = -0.50; p = 0.002) levels. Twelve (21.4%) patients had side effects (8.7% in the SI group vs. 30.3% in the FHPC group [p = 0.006]), leading to iron discontinuation in 5 (4/1: FHPC group/SI group). Both iron formulations had similar efficacy. There were fewer side effects in the SI group. Oral iron replacement improved Hb and iron levels after 12 weeks of treatment, and these changes correlated with improvement in disability.

Introduction: Malignant biliary obstruction drainage is essential, since jaundice is associated with morbidity and mortality. Endoscopic retrograde cholangiopancreatography (ERCP) is the recommended procedure for biliary drainage, with percutaneous biliary drainage being the classic alternative in cases of unsuccessful ERCP. Recently, endoscopic ultrasound-guided biliary drainage has been emerged as a new option, with EUS-guided choledochoduodenostomy (EUS-CDS) being considered an effective and safe method in the drainage of distal obstructions of the common bile duct. Aim: The aim of the study was to evaluate the efficacy and safety of EUS-CDS performed in patients with distal malignant biliary obstructions, after failed ERCP. Methods: Single-center retrospective cohort study between July 2017 and June 2022 including all consecutive patients submitted to EUS-CDS in our center. The primary outcomes were “technical success” and “clinical success,” defined as “resolution of jaundice or improvement in total serum bilirubin level above 50% at 7th day and above 75% at 30th day after the procedure.” Secondary outcomes were procedure-related adverse events, endoscopic reintervention, and survival time. Results: EUS-CDS was performed in 20 patients (65.0% male; median age 76 years). The most frequent etiology for the biliary obstruction was pancreatic adenocarcinoma (n = 17; 85.0%), and most patients presented at advanced stages of cancer (12/60% in stages III or IV). ERCP failure was mainly due to the presence of obstruction in the duodenal lumen (n = 11; 55.0%). Fully covered metallic stents were used in all patients, mostly HotAxiosTM (n = 15; 75.0%). The technical success rate was 100%, and the clinical success rate was 89.5% (n = 17/19) at 7th day and 93.3% (n = 14/15) at 30th day. Four patients (20.0%) developed cholangitis within the first 30 days after the procedure; there were no late complications, and no patient died as a complication of the procedure. In 2 patients (10.0%), endoscopic reintervention was necessary due to stent migration, incidentally detected. Median survival was 93 days (minimum 5–maximum 751). Conclusion: EUS-CDS was effective in biliary decompression of malignant obstructions of the common bile duct, with high clinical success and a favorable safety profile.

[This corrects the article DOI: 10.1159/000524060.].

[This corrects the article DOI: 10.1159/000526059.].

[This corrects the article DOI: 10.1159/000526060.].

[This corrects the article DOI: 10.1159/000524062.].

[This corrects the article DOI: 10.1159/000524420.].