Iron deficiency and anaemia in people with inflammatory bowel disease: do we have an ongoing issue of care quality? Crohn's Colitis Cure data insights programme

Background Inflammatory bowel disease (IBD) increases the risk of nutritional deficiencies, particularly iron deficiency (ID). ID and anaemia are not routinely tracked in IBD care, with reported rates of ID in IBD cohorts varying from 23% to 90% worldwide. Aims To examine current rates of iron deficiency and subsequent anaemia in a large national cohort of people under routine IBD care. Methods Rates of ID and/or anaemia were explored in a multisite Australasian IBD point‐of‐care documentation system – Crohn's Colitis Care (CCCare). Patients with a clinical encounter within 14 months were included. ID was defined as serum ferritin <30 μg/L or transferrin saturation <16% (if ferritin >30 μg/L). Anaemia was defined as haemoglobin <130 g/L in men and <115 g/L in women. CCCare was interrogated in September 2024. Results Among 7493 eligible people, 35.2% ( n = 2615) had iron studies and haemoglobin recorded. ID was found in 25.4% ( n = 663), with a comparable rate among IBD subtypes: 26.1% in Crohn's disease, 23.7% in ulcerative colitis and 30.3% in IBD‐unclassified. Of those with ID, 22.8% ( n = 151) had concurrent anaemia. The most common form of iron replacement was ferric carboxymaltose ( n = 67, 69.8%); yet overall, only 96 of 673 (14.5%) with ID were documented to have been given iron replacement. Conclusions Despite being a well‐known issue in IBD, easily diagnosed and treated, ID remains highly prevalent in routine care in this large real‐world cohort. ID is more common than ID with anaemia, yet both likely impair quality of life. Protocolised screening and repletion may be needed to ensure consistency, and approaches such as benchmarking or open data reporting on key performance indicators may need to be implemented to drive change at scale.