***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES : Anemia is a frequent complication in patients with inflammatory bowel disease ( IBD ) . The optimal route for iron supplementation to replenish iron stores has not been determined so far . We therefore evaluated the efficacy and safety of intravenous iron sucrose as compared with oral iron sulfate for the treatment of iron deficiency anemia ( IDA ) in patients with IBD . METHODS : A r and omized , prospect i ve , open-label , multicenter study was performed in 46 patients with anemia and transferrin saturation ≤20 % and /or serum ferritin concentrations ≤20 μg/L. The intravenous group received a single dose of iron sucrose of 7 mg iron/kg body weight , followed by five 200 mg infusions for the following 5 wks . The oral group received iron sulfate 100–200 mg per day for 6 wks . RESULTS : While a comparable increase in hemoglobin was observed for both administration routes ( median increase 0.25 g/L in the intravenous group vs 0.21 g/L in the oral group ) , only iron sucrose led to a rise in serum ferritin concentrations . Intractable gastrointestinal adverse events caused permanent study drug discontinuation in five patients ( 20.8 % ) receiving iron sulfate , whereas only one patient ( 4.5 % ) had to be withdrawn because of side effects due to iron sucrose . CONCLUSIONS : Although being equal in short-term efficacy and overall tolerability our results suggest a better gastrointestinal tolerability for iron sucrose . Larger trials are m and atory to prove a possible advantage of iron sucrose in short- and long-term efficacy as well as in tolerability over iron sulfate in the management of IDA in IBD OBJECTIVES : In the largest head-to-head comparison between an oral and an intravenous ( IV ) iron compound in patients with inflammatory bowel disease ( IBD ) so far , we strived to determine whether IV iron isomaltoside 1,000 is non-inferior to oral iron sulfate in the treatment of iron deficiency anemia ( IDA ) . METHODS : This prospect i ve , r and omized , comparative , open-label , non-inferiority study was conducted at 36 sites in Europe and India . Patients with known intolerance to oral iron were excluded . A total of 338 IBD patients in clinical remission or with mild disease , a hemoglobin ( Hb ) < 12 g/dl , and a transferrin saturation ( TSAT ) < 20 % were r and omized 2:1 to receive either IV iron isomaltoside 1,000 according to the Ganzoni formula ( 225 patients ) or oral iron sulfate 200 mg daily ( equivalent to 200 mg elemental iron ; 113 patients ) . An interactive web response system method was used to r and omize the eligible patient to the treatment groups . The primary end point was change in Hb from baseline to week 8 . Iron isomaltoside 1,000 and iron sulfate was compared by a non-inferiority assessment with a margin of −0.5 g/dl . The secondary end points , which tested for superiority , included change in Hb from baseline to weeks 2 and 4 , change in s-ferritin , and TSAT to week 8 , number of patients who discontinued study because of lack of response or intolerance of investigational drugs , change in total quality of life ( QoL ) score to weeks 4 and 8 , and safety . Exploratory analyses included a responder analysis ( proportion of patients with an increase in Hb ≥2 g/dl after 8 weeks ) , the effect of regional differences and total iron dose level , and other potential predictors of the treatment response . RESULTS : Non-inferiority in change of Hb to week 8 could not be demonstrated . There was a trend for oral iron sulfate being more effective in increasing Hb  than iron isomaltoside 1,000 . The estimated treatment effect was −0.37 ( 95 % confidence interval ( CI ) : −0.80 , 0.06 ) with P=0.09 in the full analysis set ( N=327 ) and −0.45 ( 95 % CI : −0.88 , −0.03 ) with P=0.04 in the per protocol analysis set ( N=299 ) . In patients treated with IV iron isomaltoside 1,000 , the mean change in s-ferritin concentration was higher with an estimated treatment effect of 48.7 ( 95 % CI : 18.6 , 78.8 ) with P=0.002 , whereas the mean change in TSAT was lower with an estimated treatment effect of −4.4 ( 95 % CI : −7.4 , −1.4 ) with P=0.005 , compared with patients treated with oral iron . No differences in changes of QoL were observed . The safety profile was similar between the groups . The proportion of responders with Hb ≥2 g/dl ( IV group : 67 % ; oral group : 61 % ) were comparable between the groups ( P=0.32 ) . Iron isomaltoside 1,000 was more efficacious with higher cumulative doses of > 1,000 mg IV . Significant predictors of Hb response to IV iron treatment were baseline Hb and C-reactive protein ( CRP ) . CONCLUSIONS : We could not demonstrate non-inferiority of IV iron isomaltoside 1,000 compared with oral iron in this study . Based on the dose – response relationship observed with the IV iron compound , we suggest that the true iron dem and of IV iron was underestimated by the Ganzoni formula in our study . Alternative calculations including Hb and CRP should be explored to gauge iron stores in patients with IBD Background : Intravenous iron and erythropoietin have been shown to be effective in Crohn ’s disease-associated anemia . The aim of this study was to test the sequential treatment of anemia in ulcerative colitis with intravenous iron in the first phase and erythropoietin in the second . Patients and Methods : Twenty patients with ulcerative colitis-associated anemia ( hemoglobin ≤10.5 g/dl ) entered this open-label trial . In the first phase all patients received intravenous iron saccharate for 8 weeks . A response was defined as an increase in hemoglobin ≥2.0 g/dl ; a final hemoglobin > 10.5 g/dl was regarded as full response , ≤10.5 g/dl as partial response . A hemoglobin increase < 2.0 g/dl was regarded as nonresponse . In the second phase ( n = 4 ) erythropoietin was initiated in patients without response . Patients with partial response were continued on iron saccharate for another 8 weeks . Results : During the first phase the hemoglobin increased from 8.3 to 11.9 g/dl ( mean hemoglobin difference 3.6 ± 2.3 g/dl , p < 0.001 ) . Fifteen patients ( 75 % ) showed a full response ( mean hemoglobin difference 4.5 ± 1.5 g/dl ) , 1 ( 5 % ) a partial response ( hemoglobin difference 2.1 g/dl ) and 4 no response ( mean hemoglobin difference 0.4 ± 1.8 g/dl ) with a need for blood transfusions in a single patient . In the second study  phase erythropoietin  was highly effective in previous nonresponders ( mean hemoglobin difference 3.3 ± 1.9 g/dl ) . The single patient with partial response had a minor hemoglobin increase ( hemoglobin difference 1.0 g/dl ) . Conclusion : Most patients with ulcerative colitis-associated anemia improve on intravenous iron alone . Erythropoietin is effective in those who do not respond Objective . Iron therapy may reinforce intestinal inflammation by catalysing production of reactive oxygen species . The effects of oral ferrous fumarate and intravenous iron sucrose on clinical disease activity and plasma redox status were investigated in patients with inflammatory bowel disease ( IBD ) . Material and methods . Nineteen patients with iron deficiency anaemia and Crohn 's disease ( 11 ) or ulcerative colitis ( 8) were included in a crossover study . The patients were r and omly assigned to start treatment with ferrous fumarate ( Neo-fer ® ) 120 mg orally once daily or iron sucrose ( Venofer ® ) 200 mg intravenously 3 times during a period of 14 days . Clinical disease activity assessment and blood and faecal analysis were performed on days 1 and 15 . Results . Following oral ferrous fumarate  clinical disease activity ( p=0.037 ) , general well-being score ( i.e. patients felt worse ) ( p=0.027 ) and abdominal pain score ( p=0.027 ) increased , while no changes were seen following iron sucrose  treatment . C-reactive protein ( CRP ) and faecal calprotectin were unchanged after both treatments . As compared with iron sucrose , ferrous fumarate  increased Crohn 's disease activity index ( CDAI ) scores of general well-being ( p=0.049 ) , whereas alterations in clinical disease activity ( p=0.14 ) and abdominal pain score ( p=0.20 ) did not differ . Ferrous fumarate did not significantly alter plasma malondialdehyde ( MDA ) or plasma antioxidants . Iron sucrose  increased plasma MDA ( p=0.004 ) and decreased plasma vitamin C ( p=0.017 ) and betacarotene ( p=0.008 ) . Conclusions . Oral ferrous fumarate , but not intravenous iron sucrose , increased clinical disease activity in IBD patients .  Intravenous iron sucrose  increased intravascular oxidative stress OBJECTIVE Anemia is a common hematological disorder characterized by reduced hemoglobin concentrations . Despite information on prevalence and associated outcomes , little is known about the impact of anemia on health care utilization and costs . This study examines anemia prevalence and associated medical costs and utilization , using administrative cl aims for adults newly diagnosed with anemia , including up to 12 months of follow-up . METHODS Patients predisposed to anemia , based on selected comorbid conditions ( chronic kidney disease , human immunodeficiency virus , rheumatoid arthritis , inflammatory bowel disease , congestive heart failure , and solid-tumor cancers ) , were identified .  Costs for anemic patients and a r and om sample of nonanemic patients with these conditions were compared . Associations were evaluated after adjustment for potential confounders using a regression model . Clinical care patterns were examined overall and by condition . RESULTS  Anemia  was observed in 3.5 % ( 81,423 ) of approximately 2.3 million health plan members in 2000 ; 15 % of anemic patients received an identified treatment , with transfusion being the most frequent intervention . Utilization and costs were significantly higher for anemic patients ( P < 0.001 ) . Average annualized per-patient costs were 14,535 US dollars for anemic patients ( 55 % outpatient , 33 % inpatient , 13 % pharmacy ) , 54 % higher than the 9,451 US dollars average cost for nonanemic patients ( 45 % outpatient , 36 % inpatient , 19 % pharmacy ) . After adjustment for age , other comorbidities ( e.g. , chronic kidney disease and cancer ) , sex , and insurance type ( indemnity , preferred provider organization/point of service , or health maintenance organization , in the Medstat MarketScan data base ) , anemic patients had average costs that were more than twice the adjusted costs of nonanemic patients . CONCLUSION Medical costs for anemic patients are as much as twice those for nonanemic patients with the same comorbid conditions BACKGROUND AIMS : Anemia is a common complication of inflammatory bowel diseases ( IBD ) This multicenter study tested the noninferiority and safety of a new intravenous iron preparation , ferric carboxymaltose ( FeCarb ) , in comparison with oral ferrous sulfate ( FeSulf ) in reducing iron deficiency anemia ( IDA ) in IBD . METHODS : Two hundred patients were r and omized in a 2:1 ratio ( 137 FeCarb:63 FeSulf ) to receive FeCarb ( maximum 1,000 mg iron per infusion ) at 1-wk intervals until the patients ' calculated total iron deficit was reached or FeSulf ( 100 mg b.i.d . ) for 12 wk . The primary end point was change in hemoglobin ( Hb ) from baseline to week 12 . RESULTS : The median Hb improved from 8.7 to 12.3 g/dL in the FeCarb group and from 9.1 to 12.1 g/dL in the FeSulf group , demonstrating noninferiority ( P = 0.6967 ) . Response ( defined as Hb increase of > 2.0 g/dL ) was higher for FeCarb at week 2 ( P = 0.0051 ) and week 4 ( P = 0.0346 ) . Median ferritin increased from 5.0 to 323.5 μg/L at week 2 , followed by a continuous decrease in the FeCarb group ( 43.5 μg/L at week 12 ) . In the FeSulf group , a moderate increase from 6.5 to 28.5 μg/L at week 12 was observed . Treatment-related 
    Output:
    
CONCLUSIONS Ferric carboxymaltose was the most effective intravenous iron formulation , followed by iron sucrose .
In addition , ferric carboxymaltose tended to be better tolerated .