Weisshof R, Chermesh I. Micronutrient deficiencies in inflammatory bowel disease. Curr Opin Clin Nutr Metab Care. 2015;18:576-581.
Hwang C, Ross V, Mahadevan U. Micronutrient deficiencies in inflammatory bowel disease: from A to zinc. Inflamm Bowel Dis. 2012;18:1961-1981.
Niepel D, Klag T, Malek NP, et al. Practical guidance for the management of iron deficiency in patients with inflammatory bowel disease. Ther Adv Gastroenterol. 2018;11:1756284818769074.
Hou JK, Gasche C, Drazin NZ, et al. Assessment of gaps in care and the development of a care pathway for anemia in patients with inflammatory bowel diseases. Inflamm Bowel Dis. 2017;23:35-43.
Mayo Clinic. Rochester 2018 Interpretive Handbook. https://www.mayomedicallaboratories.com/test-catalog/pod/MayoTestCatalog-Rochester--SortedByTestName-duplex-interpretive.pdf. Updated October 18, 2018. Accessed October 2018.
World Health Organization. Nutritional anemias: tools for effective prevention and control. http://apps.who.int/iris/bitstream/handle/10665/259425/9789241513067-eng.pdf?sequence=1. Published 2017. Accessed October 2018.
Dignass AU, Gasche C, Bettenworth D, et al. European consensus on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases. J Crohns Colitis. 2015;9:211-222.
Mücke V, Mücke MM, Raine T, et al. Diagnosis and treatment of anemia in patients with inflammatory bowel disease. Ann Gastroenterol. 2017;30:15-22.
Iron Disorders Institute. Iron we consume. http://www.irondisorders.org/iron-we-consume/. Accessed October 2018.
Nielsen OH, Soendergaard C, Vikner ME, et al. Rational management of iron-deficiency anemia in inflammatory bowel disease. Nutrients. 2018;10:82.
Aksan A, Işık H, Radeke HH, et al. Systematic review with network meta-analysis: comparative efficacy and tolerability of different intravenous iron formulations for the treatment of iron deficiency anaemia in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2017;45:1303-1318.
Akhuemonkhan E, Parian A, Carson KA, et al. Adverse reactions after intravenous iron infusion among inflammatory bowel disease patients in the United States, 2010-2014. Inflamm Bowel Dis. 2018;24:1801-1807.
Adkinson NF, Strauss WE, Macdougall IC, et al. Comparative safety of intravenous ferumoxytol versus ferric carboxymaltose in iron deficiency anemia: a randomized trial. Am J Hematol. 2018;93:683-690.
Prats M, Font R, García C, et al. Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post-hoc analysis of a prospective study. BMC Nephrol. 2013;14:167.
Hardy S, Vandemergel X. Intravenous iron administration and hypophosphatemia in clinical practice. Int J Rheumatol. 2015;2015:468675.

Moderator

David T. Rubin, MD

Professor of Medicine
Chief
Section of Gastroenterology, Hepatology, and Nutrition
Co-Director
Digestive Diseases Center
University of Chicago
Chicago, Illinois

Disclosures

Disclosure: David T. Rubin, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AbbVie Inc.; Abgenomics; Allergan, Inc.; Arena Pharmaceuticals, Inc.; Ferring Pharmaceuticals; Genentech, Inc.; Janssen Pharmaceuticals; Lilly; Medtronic, Inc.; Merck & Co., Inc.; Napo Pharmaceuticals; Pfizer Inc.; Roche; Shire; Takeda Pharmaceuticals North America, Inc.; Target PharmaSolutions, Inc.
Received grants for clinical research from: AbbVie Inc.; Genentech, Inc.; Janssen Pharmaceuticals; Prometheus Laboratories Inc.; Roche; Shire; Takeda Pharmaceuticals North America, Inc.

Dr Rubin does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Rubin does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Panelists

Jason Ken Hou, MD, MS

Assistant Professor of Medicine
Research Director
Inflammatory Bowel Disease Center
Program Director
Gastroenterology Fellowship Program
Baylor College of Medicine
Houston, Texas

Disclosures

Disclosure: Jason Ken Hou, MD, MS, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AbbVie Inc.; Janssen Pharmaceuticals; Pfizer Inc.
Served as a speaker or a member of a speakers bureau for: AbbVie Inc.; Janssen Pharmaceuticals
Received grants for clinical research from: AbbVie Inc.; Celgene Corporation; Janssen Pharmaceuticals; Lycera; Pfizer Inc.; Redhill Biopharma; Shield Therapeutics

Dr Hou does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Hou does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Raluca Vrabie, MD

Assistant Professor of Clinical Medicine
Stony Brook School of Medicine
IBD Program Director
Winthrop University Hospital
Mineola, New York

Disclosures

Disclosure: Raluca Vrabie, MD, has disclosed no relevant financial relationships.

Dr Vrabie does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Vrabie does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Kelly Issokson, MS, RD, CNSC

Registered Dietitian
Cedars-Sinai Medical Center
Los Angeles, California

Disclosures

Disclosure: Kelly Issokson, MS, RD, CNSC, has disclosed no relevant financial relationships.

Ms Issokson does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Ms Issokson does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor

Kalanethee Paul-Pletzer, PhD

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Kalanethee Paul-Pletzer, PhD, has disclosed no relevant financial relationships.

CME Reviewer / Nurse Planner

Amy Bernard, MS, BSN, RN-BC, CHCP

Lead Nurse Planner, Medscape, LLC

Disclosures

Disclosure: Amy Bernard, MS, BSN, RN-BC, CHCP, has disclosed no relevant financial relationships.

CME / ABIM MOC / CE

Getting It Right: How to Manage Nutrient Deficiencies in IBD

Authors: David T. Rubin, MD; Jason Ken Hou, MD, MS; Raluca Vrabie, MD; Kelly Issokson, MS, RD, CNSC
CME / ABIM MOC / CE Released: 12/4/2018
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 12/4/2019, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for gastroenterologists, nephrologists, and primary care physicians.

The goal of this activity is to increase clinicians' awareness of nutrient deficiencies in inflammatory bowel disease (IBD) and clinician's confidence in assessing and managing nutrient deficiencies in IBD, particularly iron deficiency anemia (IDA).

Upon completion of this activity, participants will be able to:

Have greater competence related to
- Implementing a team-based approach to assessing patients for common nutrient deficiencies in IBD
- Tailoring treatment options for iron deficiency anemia based on patient presentation and clinical data
Have increased knowledge regarding the
- Clinical data on IV iron preparations to guide treatment decisions

Moderator

David T. Rubin, MD

Professor of Medicine
Chief
Section of Gastroenterology, Hepatology, and Nutrition
Co-Director
Digestive Diseases Center
University of Chicago
Chicago, Illinois

Disclosures

Disclosure: David T. Rubin, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AbbVie Inc.; Abgenomics; Allergan, Inc.; Arena Pharmaceuticals, Inc.; Ferring Pharmaceuticals; Genentech, Inc.; Janssen Pharmaceuticals; Lilly; Medtronic, Inc.; Merck & Co., Inc.; Napo Pharmaceuticals; Pfizer Inc.; Roche; Shire; Takeda Pharmaceuticals North America, Inc.; Target PharmaSolutions, Inc.
Received grants for clinical research from: AbbVie Inc.; Genentech, Inc.; Janssen Pharmaceuticals; Prometheus Laboratories Inc.; Roche; Shire; Takeda Pharmaceuticals North America, Inc.

Dr Rubin does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Rubin does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Panelists

Jason Ken Hou, MD, MS

Assistant Professor of Medicine
Research Director
Inflammatory Bowel Disease Center
Program Director
Gastroenterology Fellowship Program
Baylor College of Medicine
Houston, Texas

Disclosures

Disclosure: Jason Ken Hou, MD, MS, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AbbVie Inc.; Janssen Pharmaceuticals; Pfizer Inc.
Served as a speaker or a member of a speakers bureau for: AbbVie Inc.; Janssen Pharmaceuticals
Received grants for clinical research from: AbbVie Inc.; Celgene Corporation; Janssen Pharmaceuticals; Lycera; Pfizer Inc.; Redhill Biopharma; Shield Therapeutics

Dr Hou does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Hou does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Raluca Vrabie, MD

Assistant Professor of Clinical Medicine
Stony Brook School of Medicine
IBD Program Director
Winthrop University Hospital
Mineola, New York

Disclosures

Disclosure: Raluca Vrabie, MD, has disclosed no relevant financial relationships.

Dr Vrabie does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Vrabie does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Kelly Issokson, MS, RD, CNSC

Registered Dietitian
Cedars-Sinai Medical Center
Los Angeles, California

Disclosures

Disclosure: Kelly Issokson, MS, RD, CNSC, has disclosed no relevant financial relationships.

Ms Issokson does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Ms Issokson does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor

Kalanethee Paul-Pletzer, PhD

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Kalanethee Paul-Pletzer, PhD, has disclosed no relevant financial relationships.

CME Reviewer / Nurse Planner

Amy Bernard, MS, BSN, RN-BC, CHCP

Lead Nurse Planner, Medscape, LLC

Disclosures

Disclosure: Amy Bernard, MS, BSN, RN-BC, CHCP, has disclosed no relevant financial relationships.

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Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

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There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

Read the target audience, learning objectives, and author disclosures.
Study the educational content online or printed out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

From Medscape Education Gastroenterology

CME / ABIM MOC / CE

Getting It Right: How to Manage Nutrient Deficiencies in IBD

Authors: David T. Rubin, MD; Jason Ken Hou, MD, MS; Raluca Vrabie, MD; Kelly Issokson, MS, RD, CNSCFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC / CE Released: 12/4/2018

Valid for credit through: 12/4/2019, 11:59 PM EST

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The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Moderator

David T. Rubin, MD

Panelists

Jason Ken Hou, MD, MS

Raluca Vrabie, MD

Kelly Issokson, MS, RD, CNSC

Editor

Kalanethee Paul-Pletzer, PhD

CME Reviewer / Nurse Planner

Amy Bernard, MS, BSN, RN-BC, CHCP

CME / ABIM MOC / CE

Getting It Right: How to Manage Nutrient Deficiencies in IBD

Target Audience and Goal Statement

Moderator

David T. Rubin, MD

Panelists

Jason Ken Hou, MD, MS

Raluca Vrabie, MD

Kelly Issokson, MS, RD, CNSC

Editor

Kalanethee Paul-Pletzer, PhD

CME Reviewer / Nurse Planner

Amy Bernard, MS, BSN, RN-BC, CHCP

Accreditation Statements

For Physicians

For Nurses

Instructions for Participation and Credit

Getting It Right: How to Manage Nutrient Deficiencies in IBD