Treatment Of Iron Deficiency Anemia Research Articles

A case report on the use of Ayurveda in the treatment of Iron Deficiency Anaemia

Among pregnant women and young children, nutritional iron deficiency anaemia is a worldwide public health concern and the leading cause of anaemia. Iron deficiency anaemia is often caused by blood loss or mal-absorption. Iron deficiency anaemia and Pandu Roga are very similar clinical entities. Pitta Pradhan Vyadhi is Pandu Roga. The vitiated Doshas in Pandu Roga cause a disruption in tissue metabolism, which results in Dhatu-Shathilya in all of Dhatu. Paleness is the dominant colour across the body. The Rasavaha and Raktavaha Srotasas play a significant role in the development of Pandu. In this case study, we see a 22-year-old female patient with iron deficiency anaemia who, after a month of treatment with Ayurvedic formulations in the Pandu Roga line of treatment and iron-rich dietary supplements, experienced a dramatic improvement in her symptoms (less swelling, no pallor, increased energy, decreased palpitation, and hair loss of 10 strands per day) and an increase in her haemoglobin level (from 8.6g/dl to 12.7g/dl) at a very rapid pace. The Samprapti of Pandu Roga may be broken with the aid of the formulas. Iron deficiency anaemia (Pandu) may be effectively treated with Ayurvedic medication.

Evaluation of the efficacy and safety of intravenous infusion of ferric derisomaltose in the treatment of iron deficiency anemia: a single-center retrospective analysis

Objective: To investigate the clinical efficacy and safety of ferric derisomaltose injection versus iron sucrose injection in the treatment of iron deficiency anemia (IDA) . Methods: A total of 120 patients with iron deficiency anemia admitted from June 2021 to March 2023 were given intravenous iron supplementation with ferric derisomaltose to assess the efficacy and safety of hemoglobin (HGB) elevation before and after treatment. Simultaneously, the clinical effects of iron supplementation with iron sucrose were compared to those of inpatient patients during the same period. Results: Baseline values were comparable in both groups. Within 12 weeks of treatment, the elevated HGB level in the ferric derisomaltose group was higher than that of the iron sucrose group, with a statistical difference at all time points, and the proportion of HGB increased over 20 g/L in the patients treated for 4 weeks was higher (98.7%, 75.9% ). During the treatment with ferric derisomaltose and iron sucrose, the proportion of mild adverse reactions in the ferric derisomaltose group was slightly lower than that of the iron sucrose group, and neither group experienced any serious adverse reactions. The patients responded well to the infusion treatment, with no reports of pain or pigmentation at the injection site. Conclusion: The treatment of IDA patients with ferric derisomaltose has a satisfactory curative effect, with the advantages of rapidity, accuracy, and safety. Therefore, it is worthy of widespread clinical use.

Acceptability of IV iron treatment for iron deficiency anaemia in pregnancy in Nigeria: a qualitative study with pregnant women, domestic decision-makers, and health care providers

BackgroundAnaemia in pregnancy causes a significant burden of maternal morbidity and mortality in sub-Saharan Africa, with prevalence ranging from 25 to 45% in Nigeria. The main treatment, daily oral iron, is associated with suboptimal adherence and effectiveness. Among pregnant women with iron deficiency, which is a leading cause of anaemia (IDA), intravenous (IV) iron is an alternative treatment in moderate or severe cases. This qualitative study explored the acceptability of IV iron in the states of Kano and Lagos in Nigeria.MethodsWe purposively sampled various stakeholders, including pregnant women, domestic decision-makers, and healthcare providers (HCPs) during the pre-intervention phase of a hybrid clinical trial (IVON trial) in 10 healthcare facilities across three levels of the health system. Semi-structured topic guides guided 12 focus group discussions (140 participants) and 29 key informant interviews. We used the theoretical framework of acceptability to conduct qualitative content analysis.ResultsWe identified three main themes and eight sub-themes that reflected the prospective acceptability of IV iron therapy. Generally, all stakeholders had a positive affective attitude towards IV iron based on its comparative advantages to oral iron. The HCPs noted the effectiveness of IV iron in its ability to evoke an immediate response and capacity to reduce anaemia-related complications. It was perceived as a suitable alternative to blood transfusion for specific individuals based on ethicality. However, to pregnant women and the HCPs, IV iron could present a higher opportunity cost than oral iron for the users and providers as it necessitates additional time to receive and administer it. To all stakeholder groups, leveraging the existing infrastructure to facilitate IV iron treatment will stimulate coherence and self-efficacy while strengthening the existing trust between pregnant women and HCPs can avert misconceptions. Finally, even though high out-of-pocket costs might make IV iron out of reach for poor women, the HCPs felt it can potentially prevent higher treatment fees from complications of IDA.ConclusionsIV iron has a potential to become the preferred treatment for iron-deficiency anaemia in pregnancy in Nigeria if proven effective. HCP training, optimisation of information and clinical care delivery during antenatal visits, uninterrupted supply of IV iron, and subsidies to offset higher costs need to be considered to improve its acceptability.Trial registration ISRCTN registry ISRCT N6348 4804. Registered on 10 December 2020 Clinicaltrials.gov NCT04976179. Registered on 26 July 2021

Clinical efficacy of polysaccharide iron complex plus vitamin C in the treatment of iron deficiency anemia in pregnancy and their effect on iron metabolism

Purpose: To evaluate the clinical efficacy of polysaccharide iron complexes (PIC) plus vitamin C in treating iron deficiency anemia (IDA) during pregnancy and its effect on iron metabolism.Methods: Ninety pregnant women with IDA in their second trimester admitted into the Department of Gynaecology and Obstetrics, Nanchang Third Hospital, Jiangxi Province, China between June 2019 and June 2021 were randomly and equally assigned to receive either PIC (two 500 mg capsules daily) alone (control group) or PIC plus vitamin C (0.1 g daily) (study group) for 4 weeks. Efficacy was determined by changes in clinical symptoms and blood indices and iron metabolism indices (serum ferritin, serum iron, hepcidin, transferrin saturation) pre- and post-treatment. Adverse pregnancy outcomes were also recorded.Results: Both groups were comparable at baseline. Post-treatment, study group showed significantly higher red blood cell (RBC), hemoglobin (Hb), mean red blood cell volume (MCV) and mean corpuscular hemoglobin (MCH) compared to control group (p < 0.05). Iron metabolism indices also significantly improved in study group with serum ferritin (SF), serum iron (SI), hepcidin (Hepc), and transferrin saturation (TSAT) (p < 0.05). The total clinical efficacy was higher in study group (p < 0.05), and the incidence of adverse pregnancy outcomes was lower (p < 0.05).Conclusions: The combination of PIC with vitamin C significantly improves the hematological indices, enhances iron metabolism, and reduces adverse pregnancy outcomes compared to PIC alone in pregnant women with IDA. Further studies with larger sample sizes are warranted to validate these results.

IV ferric carboxymaltose (Injectafer) for iron deficiency in heart failure.

Ferric carboxymaltose (Injectafer – American Regent) is now FDA-approved for IV treatment of iron deficiency in adults with New York Heart Association (NYHA) class II/III heart failure to improve exercise capacity. Iron deficiency is present in approximately 30% of patients with heart failure; it has been associated with reduced quality of life and increased hospitalization and mortality. Injectafer is the first IV iron preparation to be approved for this indication. It was previously approved for treatment of iron deficiency anemia in children and adults.

Effect of oral vitamin C administration along with iron supplementation for treating anaemia among adolescent girls - Protocol for systematic review and meta-analysis.

Anemia among adolescent girls is a worldwide public health problem. Although anemia has several causes, the most common and significant is iron deficiency. Treatment of anemia with iron alone may result in reduced compliance on account of adverse effects. Various studies have revealed that use of vitamin C in addition to iron improves its absorption and reduces the ill effects of the therapy. However, a concrete evidence of adding vitamin C to iron for treating iron deficiency anemia is lacking. Protocol for current systematic review was prepared and registered with the aim to generate evidence on role of vitamin C in addition to iron for treatment of anemia. Present protocol has been prepared based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with International Prospective Register of Systematic Reviews. Data extraction will be done by the reviewers independently. Cochrane risk of bias assessment tool will be used for risk of bias assessment. For primary outcome and each of the other outcomes pairwise random effects meta-analysis and network meta-analysis will be performed. Sensitivity analysis will be performed in case of any heterogeneity is detected to find out the difference of the effect estimation between subsets. The evidence for role of vitamin C as an adjunct in iron and folic acid for treatment of anemia in adolescent girls will be generated once the systematic review and meta-analysis is completed.

Expert consensus guidelines: Intravenous iron uses, formulations, administration, and management of reactions.

Intravenous iron has become an essential component for the treatment of iron deficiency and iron deficiency anemia. Individuals administering Intravenous iron should have knowledge in intravenous iron administration, including a pre-infusion assessment to evaluate infusion reaction risks, pre- and post-infusion monitoring, identification of and management of infusion reactions, accurate documentation of these reactions, laboratory monitoring and recognition and management of treatment-emergent hypophosphatemia. This comprehensive consensus provides step-by-step guidance and tools for practitioners to promote safe delivery of intravenous iron, recognition, and management of infusion reactions and treatment-emergent hypophosphatemia.

P580 Iron deficiency anaemia and quality of life in Inflammatory Bowel Disease: Prospective cohort study of ferric derisomaltose on quality of life and work productivity in patients with IBD

Abstract Background Iron-deficiency anaemia is a frequent complication of inflammatory bowel disease (IBD), affecting approximately 10% of patients at any one time. Quality of life scores in patients with IBD and anaemia are similar to those reported in malignancy. ECCO guidelines recommend assessment and treatment of iron deficiency anaemia, with a goal of normalising haemoglobin and iron stores. Methods We conducted a prospective observational cohort study of patients with IBD being treated for iron deficiency anaemia with ferric derisomaltose. Patients were included who were anaemic as per World Health Organisation criteria with a ferritin of <30 µg/L and/or a transferrin saturation of <18%. Variables collected included haematological parameters, the 12-item Short Form survey (SF-12) as a generic health-related quality of life measure, the Work Productivity and Activity Impairment (WPAI) questionnaire and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) as a disease-specific quality of life measure. Patients were assessed at baseline, 12 weeks and 52 weeks. We present here the outcomes at week 12. Comparative statistics have been conducted using Wilcoxon signed rank tests and Pearson’s correlation coefficient. Results We recruited 124 patients given between 700 and 1900 mg of ferric derisomaltose, each as a single infusion. Of these, 60% (74/124) were female and the median age was 43 years (IQR 31 – 58). Just under half (46%) of participants had Crohn’s disease, the remainder had ulcerative colitis (49%) or IBD unclassified (5%). Median (IQR) baseline haemoglobin was 114 (109 – 123) g/L in men and 110 (104 – 116) g/L in women. By week 12, haemoglobin, ferritin, SIBDQ, the WPAI, and both the mental and physical component scores of the SF-12 had improved significantly (all p values <0.0001; see Figure 1). Change in the physical score of SF-12 correlated positively with change in haemoglobin (r = 0.38, p<0.0001), while the change in WPAI correlated negatively with change in haemoglobin (r = -0.30, p=0.013). Conclusion Treatment with intravenous ferric derisomaltose in patients with iron deficiency anaemia and IBD was associated with significant improvements in haematological, work productivity, and quality of life parameters.

Parenteral Iron Therapy for Pediatric Patients

Iron deficiency (ID) is by far the most common nutritional disorder in developing and developed countries. When left untreated, ID leads to anemia. Although the usually recommended treatment for iron deficiency anemia (IDA) is oral iron therapy with countless products, such therapy necessitates administration for >3–6 months with questionable patient compliance since most oral iron products have an unpleasant metallic aftertaste and cause intestinal side effects. In addition, in certain gastrointestinal conditions, such as inflammatory bowel diseases or untreated gluten-sensitive enteropathy, oral iron therapy is contraindicated or unsuccessful. Intravenous iron is considered safe in adults, where adverse events are mild and easily managed. The experience with parenteral iron in children is much more limited, and many pediatricians appear reluctant to use it because of uncorroborated fears of serious anaphylactic reactions. In the current article, we thoroughly review the available pediatric literature on the use of all commercially available parenteral iron products except ferumoxytol, which was recently removed from the market. We conclude that parenteral iron appears to be safe in children; it works faster than oral iron, and the newer third-generation products allow replacement of the total iron deficit in a single sitting.

Pharmacotherapeutics for iron deficiency anemia in adults

Background: Iron deficiency anemia (IDA) is among the five greatest causes of disability globally. It can have various causes and may develop concurrently with other health issues. Recently, there have been advances in the treatment of IDA associated with various comorbidities.Current Concepts: The causes of IDA include chronic blood loss, inadequate iron absorption, and increased iron demand. Oral iron supplements are primarily recommended for the treatment of IDA. In cases where oral supplements are ineffective or cannot be used, parenteral iron supplements are administered.Discussion and Conclusion: Identifying the underlying reason for IDA is essential for determining the appropriate and effective treatment plan. In adults, it is important to be aware that gastrointestinal malignancies can be detected as a cause of IDA. Ferrous sulfate tablets are primarily recommended as oral supplements for treating IDA. Among the parenteral iron supplements available in South Korea, both iron sucrose and ferric carboxymaltose can be used relatively safely without significant side effects. Recently, ferric carboxymaltose was reported as being effective for treating iron deficiency associated with heart failure, chronic kidney disease, inflammatory bowel disease, and preoperative IDA.

Effectiveness of Lesser Known Homoeopathic Medicines in the Treatment of Iron Deficiency Anaemia

Anaemia is a major public health problem in India as it is estimated that most of the non-pregnant women of reproductive age group are anaemic. It occurs when there is decreased level of haemoglobin in red blood cells. The primary cause of anaemia is iron deficiency. Iron deficiency anaemia (IDA) may be present with other systemic diseases. People with mild and moderate iron deficiency anaemia may not have any sign and symptom. But more severe iron deficiency anaemia may cause fatigue, tiredness, shortness of breath or chest pain. Although Homoeopathy gives importance to the individualisation of the patients, for remedy selection, still then, some medicines are prescribed based on disease diagnostic features. Such medicines are not well proved, so they are known as rare/lesser-known medicines. Of course, their role in the management of certain diseases cannot be ignored. This article aims at showing the effectiveness of some lesser-known medicines in the treatment of iron deficiency anaemia.

Clinical effectiveness of ferric carboxymaltose (iv) versus iron sucrose (iv) in treatment of iron deficiency anaemia in pregnancy: A systematic review and meta-analysis.

Iron deficiency anaemia (IDA) during pregnancy is treated with oral and parenteral iron. The objective of this review was to compare the clinical effectiveness, safety, pregnancy and neonatal outcomes of intravenous (iv) ferric carboxymaltose (FCM) and iv iron sucrose (IS) in treating IDA in pregnancy. The Department of Health Research funded this study. PubMed, Cochrane Library, EMBASE and Scopus were searched to include studies published till November 2022. The protocol was registered in PROSPERO (CRD42022306092). Pregnant women (15-49 yr) in second and third trimesters, diagnosed with moderate-to-severe iron deficiency anaemia, treated with either of the drugs were included. The included studies were critically assessed using appropriate tools. We conducted a qualitative synthesis of the studies and meta-analysis for improvement in haematological parameters and incidence of adverse events. A total of 18 studies were included. The risk of bias was low to moderate. A rise in haemoglobin up to four weeks was higher with FCM than IS by 0.57 (0.24, 0.9) g/dl. Intravenous FCM is associated with fewer adverse events than IS [pooled odds ratio: 0.5 (0.32, 0.79)]. The included studies had limited evidence on pregnancy and neonatal outcomes after iv iron treatment. Intravenous FCM is effective and safer than intravenous IS in terms of haematological parameters, in treating IDA in pregnancy. Further research is required on the effects of iv FCM and iv IS on the pregnancy and neonatal outcomes when used for treating IDA in pregnancy.

Iron deficiency anemia: a critical review on iron absorption, supplementation and its influence on gut microbiota.

Iron deficiency anemia (IDA) caused by micronutrient iron deficiency has attracted global attention due to its adverse health effects. The regulation of iron uptake and metabolism is finely controlled by various transporters and hormones in the body. Dietary iron intake and regulation are essential in maintaining human health and iron requirements. The review aims to investigate literature concerning dietary iron intake and systemic regulation. Besides, recent IDA treatment and dietary iron supplementation are discussed. Considering the importance of the gut microbiome, the interaction between bacteria and micronutrient iron in the gut is also a focus of this review. The iron absorption efficiency varies considerably according to iron type and dietary factors. Iron fortification remains the cost-effective strategy, although challenges exist in developing suitable iron fortificants and food vehicles regarding bioavailability and acceptability. Iron deficiency may alter the microbiome structure and promote the growth of pathogenic bacteria in the gut, affecting immune balance and human health.

Demir Eksikliği Anemili Kadın Hastalarda İntravenöz Demir Tedavisinin Etkinliği

Abstract: In this study, it was aimed to show the efficacy of intravenous (IV) ferric carboxymaltose treatment for iron deficiency anemia (IDA), which is a public health problem due to its high prevalence in the world and in Turkey. Since it is the first study in the region, its importance is increasing even more. Eighty female diagnosed with IDA and treated with IV iron carboxymaltose, who applied to Siirt Training and Research Hospital Internal Diseases Polyclinics between June 2018 and September 2019, were included in the study. After obtaining voluntary consent of female patients, biochemical data of pre- and post-treatment were included in the study retrospectively. After treatment, hemoglobin (HGB), hematocrit (HTC), mean cell volume (MCV), ferritin, iron and B12 values increased statistically (p

Mechanism of Action and Validation of the Traditional Medicinal use of Grewia Tenax Fruits in Sudan to Encounter Iron Deficiency Anemia

Introduction: In Sudan, Grewia tenax fruits, are known commonly as Goddaim. The fruit’s pericarp is used traditionally for a long time as a juice or a porridge to treat iron deficiency anemia (IDA). Traditional Goddaim users have a very strong belief in its effectiveness. However, the pattern of hemoglobin improvement follows an initial fast increase followed by a decline upon continuing its use. Some previous studies have attributed its effect to high iron content, while the iron quantity was too small. This work attempts to find an explanation for its mechanism of action by screening the fruit extract and its respective fractions for secondary metabolites, minerals, vitamins, and fibre. Methods: Entailed three methodologies: Chemical analysis to identify quantified minerals, ascorbic acid and non-digestible fibers, Phytochemical Analysis to separate and identify secondary metabolites using high-performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS-MS technique), and estimation of radical scavenging activities of crude fruit extract and its respective chloroform and ethyl acetate fractions by inhibition of the 2,2-diphenylpicrylhydrazyl (DPPH). Results: Ascorbic acid and indigestible fibres were revealed in the aqueous extract. Secondary metabolites were flavonoids (e.g., quercetin, kaempferol), organic acids (e.g., ferulic acid, chlorogenic acid), β-carboline alkaloids (e.g., 3-hydroxy-tetrahydroharman) identified in the chloroform, and ethyl acetate fractions. The in vitro antioxidant activity of G. tenax fruit extract was confirmed spectrophotometrically. Conclusion: It can be concluded that the initial enhancement of iron absorption through ascorbic acid and fibres, followed by iron uptake inhibition, could be explained by iron chelation by the chelators in the fruits. This paradoxical effect may qualify G. tenax fruits as a safety gauge for improving haemoglobin levels without compromising iron excess once iron stores are filled by keeping the oxidative stress in check. This may present G. tenax fruits as a good and safe remedy that optimizes the treatment of IDA.

Relation of Iron Deficiency Anemia in Pre-Menopause Women with Calcium and Vitamin D Levels at Teaching Hospital

Background: Iron deficiency anemia (IDA) is a common condition influenced by various factors, such as age, symptom duration, and other biochemical markers. Premenopausal women often experience premenstrual syndrome (PMS), which is frequently associated with reduced blood levels of calcium and vitamin D. Given the worldwide public health concern of osteoporosis, understanding lifetime preventive measures is crucial. Methods: This study aimed to explore the relationship between IDA and various clinical characteristics in 161 participants. We evaluated parameters including age, symptom duration, and levels of calcium and vitamin D to identify potential associations with IDA. Data for the 161 patients were collected using a predesigned proforma, as approved by the ethics committee. The Chi-square test was employed to determine statistical significance, with a P-value threshold set at 0.05. Results: The average age of participants was 38.6 years, with the majority (58.4%) reporting symptoms for an average duration of 58.4 months. Among them, 54% had confirmed cases of IDA. However, there was no significant age-related correlation with IDA. Notably, a strong correlation was observed between IDA and low vitamin D levels, which were present in 79.8% of the patients. Conversely, no significant relationship was found between calcium levels and IDA. Conclusion: Current research underscores the complex interplay between IDA and various clinical factors. Low vitamin D levels appear to be strongly linked with IDA, whereas age and symptom duration are not reliable indicators of the condition. This emphasizes the importance of considering multiple factors in the diagnosis and treatment of IDA, particularly focusing on the potential role of vitamin D in its pathogenesis. Further prospective studies are needed to confirm and expand upon these findings, potentially leading to improved treatment and diagnostic strategies for patients with IDA.

Screening and treatment of iron deficiency anemia in pregnancy: A review and appraisal of current international guidelines

AbstractIron deficiency anemia (IDA) in pregnancy is a common diagnosis that is associated with adverse obstetric and neonatal outcomes. There remains uncertainty regarding how best to screen for, prevent, and treat established IDA in pregnancy. There is no consensus on the benefits of routine iron supplementation in pregnancy, with concerns regarding potential harmful effects of routine iron supplementation in women who are iron replete. Fourteen international guidelines were selected and appraised and compared by a multidisciplinary team. The AGREE II GRS tool was used. Each reviewer independently made their own assessment, and the scores from 1 to 7 were also collated and averaged for an overall score incorporating seven domains: process of development, clarity of presentation, completeness of reporting, clinical validity, and overall quality. The reviewers' scores were also individually compared according to discipline. The mean score across all the guidelines was 4.4 (range 3.5–6.5). Only half of the guidelines recommend routine iron in pregnancy. In terms of screening recommendations, five guidelines recommend screening with ferritin in addition to a full blood count in pregnancy, two recommend selective screening with ferritin for at risk groups only, and one guideline suggests using ferritin where feasible. Although many of the guidelines recommend similar doses of oral elemental iron of 100–200 mg daily for the treatment of established IDA in pregnancy, two recommend twice or three times daily dosing. Only five guidelines give hemoglobin rises to expect within specific timeframes. There remains a need to clarify the optimal screening method, dosing regimen, timing, and route of iron supplementation in pregnancy. Robust randomized controlled data are needed to guide appropriate prevention and management.

IV iron formulations and use in adults.

Intravenous iron has become a major component of the therapeutic armamentarium for iron deficiency and iron deficiency anemia. The earliest formulations were associated with unacceptable toxicity. Newer formulations, with complex carbohydrate cores that bind elemental iron more tightly, allow the administration of full therapeutic doses in 15 to 60 minutes. Nonetheless, a folklore of danger, fueled by earlier formulations no longer available, continues to foment caution. Complement-mediated minor infusion reactions, referred to as complement activation-related pseudo-allergy, resolve without therapy. Inappropriate intervention with vasopressors and H1 blockers converts these minor reactions into hemodynamically significant adverse events. Four new formulations, low-molecular-weight iron dextran, ferumoxytol, ferric carboxymaltose, and ferric derisomaltose, all approved for the treatment of iron deficiency in a host of conditions, are now widely used with an excellent safety profile. Herein, the administration, safety, indications, and management of infusion reactions are discussed. Treatment-emergent hypophosphatemia, a newly recognized side effect for some formulations, is also reviewed. Based on the preponderance of published evidence, intravenous iron should be moved up-front for the treatment of iron deficiency and iron deficiency anemia in those conditions in which oral iron is suboptimal.

Identifying and treating iron deficiency anemia in pregnancy.

Anemia is common during pregnancy, and while most anemia is physiologic, the most common pathologic cause is iron deficiency. The American College of Obstetricians and Gynecologists (ACOG) recommends confirmation of iron deficiency anemia with iron studies when anemia is diagnosed during pregnancy but acknowledges that presumptive treatment for suspected iron deficiency anemia is common in practice. Currently ACOG does not recommend treating iron deficiency without anemia during pregnancy. Though the benefits of treating iron deficiency anemia during pregnancy are clear, the optimal route of iron repletion remains uncertain. Results of ongoing large, randomized trials will help define the optimal route of iron treatment for pregnant patients diagnosed with iron deficiency anemia.

EE418 Cost-Utility Analysis of Ferric Derisomaltose Versus Ferric Carboxymaltose in Treating Iron Deficiency Anemia in Norwegian Patients With Inflammatory Bowel Disease

EE418 Cost-Utility Analysis of Ferric Derisomaltose Versus Ferric Carboxymaltose in Treating Iron Deficiency Anemia in Norwegian Patients With Inflammatory Bowel Disease