scholarly journals A Single Infusion of Iron Isomaltoside 1000 Allows a More Rapid Hemoglobin Increment Than Multiple Doses of Iron Sucrose with a Similar Safety Profile in Patients with Iron Deficiency Anemia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2334-2334 ◽  
Author(s):  
Michael Auerbach ◽  
Lars L Lykke
Keyword(s):  
Single Dose ◽  
Research Funding ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Hypersensitivity Reactions ◽  
Treatment Groups ◽  
Safety Endpoint ◽  
The Usa ◽  
The Mean

Abstract Introduction: Iron deficiency anemia (IDA) is prevalent and associated with reduced quality of life (QoL) and worsened disease outcomes. Oral iron administration remains the front line standard but its use is associated with an unacceptably high incidence of gastrointestinal side effects and low adherence. Further, in many conditions associated with blood loss, iron losses may exceed the capacity for oral iron absorption. Use of intravenous (IV) iron, especially if given in a single dose, may result in better compliance, fewer visits to the medical practitioner, and overall improvement in QoL. To date, no product has been licensed in the USA for single visit complete replacement dosing. To address this issue, this trial compared the safety and efficacy of iron isomaltoside 1000 with the most commonly prescribed IV formulation, iron sucrose, in patients intolerant of, or unresponsive to oral iron or likely to receive a blood transfusion. Methods: This was a randomized, open-label, comparative, multi-center trial conducted in the USA. Patients with IDA were randomized 2:1 to either iron isomaltoside administered as a single dose of 1000 mg infused over 20 min at baseline or iron sucrose administered as 200 mg IV injections according to label and repeated up to 5 times. The primary endpoints were adjudicated serious or severe hypersensitivity events starting on or after the first dose of treatment (if the upper bound of the 95 % CI was <3 %, the safety objective was met) and change in hemoglobin (Hb) from baseline to week 8. Results: A total of 1512 patients were enrolled of whom 26 % had gastrointestinal and 50 % gynecologic blood loss. The mean (standard deviation [SD]) age was 44 (15) years. The mean (SD) cumulative dose of iron was 975 (145) mg and 905 (217) mg in the iron isomaltoside and iron sucrose group, respectively. All required 1 visit for iron correction with iron isomaltoside and 4 to 5 visits for iron sucrose. The frequency of subjects with serious or severe hypersensitivity reactions was 0.3% in the iron isomaltoside group versus 0.4 % in the iron sucrose group (95% CI: 0.88 for iron isomaltoside and 1.45 for iron sucrose), meeting the primary safety endpoint. The treatment groups had statistically similar adverse drug reactions (ADRs), 12.5 % in the iron isomaltoside group and 12.8 % in the iron sucrose group. Only 0.2 % of patients in iron isomaltoside group and 0.4 % in iron sucrose group experienced serious ADRs. There were no related fatalities. The frequency of composite cardiovascular safety endpoint was 0.8 % in the iron isomaltoside group and 1.2 % in the iron sucrose group (p = 0.57). The frequency of hypophosphatemia (s-phosphate <2 mg/dL) was low and similar in the 2 groups (3.9 % in the iron isomaltoside and 2.3 % in the iron sucrose group). No patients had s-phosphate <1 mg/dL. The primary efficacy endpoint of non-inferiority in Hb change from baseline to week 8 was met. Iron isomaltoside lead to a significantly more rapid and increased Hb response in the first 2 weeks. This was reflected in both Hb change from baseline and proportion of responders with Hb increases ≥2 g/dL. Hb increased with least square means of 0.70 and 0.44 g/dL at week 1 (p <0.0001) and 1.48 and 1.19 g/dL at week 2 (p <0.0001) for iron isomaltoside and iron sucrose respectively, and the proportion of responders were 5.3 and 2.5 % at week 1 (p = 0.0077) and 32.6 and 20.8 % at week 2 (p <0.0001) for iron isomaltoside and iron sucrose respectively. Larger improvement in Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scores were observed with iron isomaltoside at week 1 (p = 0.04). A faster and greater response with iron isomaltoside was also observed for s-ferritin and transferrin saturation. Conclusion: Iron isomaltoside 1000 administered as 1000 mg in a single visit resulted in a faster and more pronounced hematological response and improvement in fatigue compared to iron sucrose which requires multiple visits. The safety profile was similar with a low frequency of hypersensitivity reactions, cardiovascular events, and serious ADRs. The frequency of hypophosphatemia was low in both treatment groups and no patients had s-phosphate <1 mg/dL. Disclosures Auerbach: AMAG Pharmaceuticals: Research Funding; Pharmacosmos A/S: Research Funding. Lykke:Pharmacosmos A/S: Employment.

scholarly journals Efficacy and safety of high dose accelerated intravenous iron sucrose in patients of iron deficiency anemia

2017 ◽  
Vol 5 (8) ◽  
pp. 3359
Author(s):  
Muzafar Naik ◽  
Tariq Bhat ◽  
Ummer Jalalie ◽  
Arif Bhat ◽  
Mir Waseem ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
High Dose ◽  
Oral Iron Therapy ◽  
The Mean

Background: Low dose (200 mg) extended Intravenous iron sucrose remains the most common treatment option in patients who are intolerant to oral iron therapy in patients with Iron deficiency anemia (IDA). The objective of this study was to evaluate the efficacy and safety of high dose accelerated intravenous iron sucrose (IS) in the treatment of adults with iron deficiency anemiaMethods: One hundred adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received daily doses of 500 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient.Results: The mean and median Hb (g/dL) 6.47±1.656 and 6.6 (2) at baseline, 9.61±1.629 and 9.6 (2) at 2 weeks of treatment, 11.85±1.277 and 12 (1) at 4 weeks of treatment respectively. The mean rise of Hb was 3.13±1.41 and 5.37±1.50 after 2 and 4 weeks of treatment respectively (p<0.000). A total of 303 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with twenty-six patients developing mild and one patient developing moderate adverse drug reactions. There was no serious adverse event recorded.Conclusions: Accelerated high dose intravenous iron sucrose is a safe and cost effective option minimizing frequent hospital visits in the treatment of adults with iron deficiency anemia who are intolerant or lack satisfactory response to oral iron therapy.

scholarly journals Title: Efficacy and Safety of Ferric Derisomaltose for Treatment of Anemia in Chronic Kidney Disease Patients: A Systematic Review

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4156-4156
Author(s):  
Atif Irfan Khan ◽  
Anam Khan ◽  
Keren Sam ◽  
Fatima Sajid ◽  
Sara Ashraf ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Single Dose ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Serum Ferritin ◽  
Research Funding ◽  
Oral Iron ◽  
Iron Therapy ◽  
Efficacy And Safety ◽  
The Mean

Abstract Background Anemia in chronic kidney disease (CKD) patients develop primarily due to iron and erythropoietin deficiency, factors contributing to this include uremia induced inhibition of erythropoiesis, shortened red cell survival and nutritional deficiency. Erythropoietin stimulating agents (ESA) used in CKD increases iron demand for the production of new red blood cells (RBCs). Oral iron does not provide a reliable route to meet the demand of the iron required and poses the risk of side effects. The intravenous formulation provides the fastest route, although multiple intravenous formulations are available they require multiple dosing and still carry a risk of an adverse event. Ferric derisomaltose/iron isomaltoside (IIM) is an intravenous formulation of iron recently approved by the Food and drug administration (FDA) for patients intolerant to oral iron and non-dialysis dependent CKD patients. FDI is administered in high dose usually in a single administration. In this systematic review, we evaluated the published literature for the efficacy and safety of ferric derisomaltose in both dialysis-dependent and dialysis independent patients. Material/Methods A literature search was done using the following databases: PubMed, Cochrane, Embase, Clinical trials.gov, and Web of Science. The search was completed without using any filter and we used the Mesh Terms for "anemia", "iron deficiency anemia" "chronic kidney disease" and "ferric compounds". Total of 316 which were further screened and we included 2 trials, and 2 prospective studies. Case reports, preclinical trials, meta-analyses, and review articles were excluded. We followed the PRISMA guidelines for literature search and selection of studies. We only included the trial studies that were completed. We excluded the studies that did not report efficacy and safety. Results In total, amongst the four studies, 1558 CKD patients received ferric derisomaltose in a single dose. Patients in all stages of CKD were studied but most patients were between stages I to stage III CKD, stage IV and V(dialysis-dependent) were studied by Kalra et al (2020). A single dose of 1000 mg/dl of IIM, was administered intravenously. The mean pre-treatment haemoglobin level varied from 9.6g/dl to 10.6 g/dl. The mean serum ferritin ranged from 82.4 µg/L to 161.9 µg/L and the mean transferrin saturation ranged in patients from 15.8% to 18.51%. IIM receiving patients were compared with iron sucrose receiving patients by Bhandari et al, and oral iron by Kalra et al (2015). The remaining two studies compared single IIM with multiple IIM dosages. The results are summarised in the table below. Efficacy: The increase in haemoglobin ranged between 0.9 g/dL to 6.58 g/dL from baseline measured at 8 weeks. At the same time, serum ferritin showed an increase in baseline serum ferritin from 104 µg/L to 277 µg/L and transferrin saturation (TSAT) increased in the range of 5.3%-11.4 %. All markers of iron deficiency showed significant improvement. It achieved a greater Hb response irrespective of ESA treatment in both haemodialysis dependent and non-dependent patients. In the comparison group by Bhandari et al, iron sucrose receiving patients also had similar efficacy as IIM. On the other hand, those receiving oral iron in the study by Kalra et al (2015) had much poorer efficacy as compared to IIM Safety: Severe adverse effect was seen in a total of 10 (0.6%) patients who developed hypersensitivity reaction, acute myocardial infarction and injection site-related adverse effects with hypersensitivity being the most common. 15 (0.9%) patients discontinued the treatment. 21 (1.3%) died, and the death was attributed to end-stage renal disease. Conclusion Ferric derisomaltose is an effective parenteral iron therapy to treat iron deficiency when compared to oral iron therapy, however, its efficacy is very similar to other parenteral iron formulations. In terms of safety, being used as a single dose it relatively has lesser adverse events but can seldom lead to discontinuation of the drug. This drug can be recommended for iron therapy especially considering single-dose administration but more studies need to be carried out in comparison to other parenteral formulations to further clarify its efficacy in dialysis-dependent CKD patients. Figure 1 Figure 1. Disclosures Anwer: BMS / Celgene: Honoraria, Research Funding; GlaxoSmithKline: Research Funding; Janssen pharmaceutical: Honoraria, Research Funding; Allogene Therapeutics: Research Funding.

scholarly journals Safety and efficacy of iron isomaltoside 1000/ferric derisomaltose versus iron sucrose in patients with chronic kidney disease: the FERWON-NEPHRO randomized, open-label, comparative trial

2020 ◽  
Vol 36 (1) ◽  
pp. 111-120 ◽  
Author(s):  
Sunil Bhandari ◽  
Philip A Kalra ◽  
Mario Berkowitz ◽  
Diogo Belo ◽  
Lars L Thomsen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Single Dose ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Iron Sucrose ◽  
Hypersensitivity Reactions ◽  
Open Label ◽  
Pronounced Increase ◽  
Safety And Efficacy ◽  
Significant Difference

Abstract Background The optimal intravenous (IV) iron would allow safe correction of iron deficiency at a single infusion over a short time. The FERWON-NEPHRO trial evaluated the safety and efficacy of iron isomaltoside 1000/ferric derisomaltose (IIM) in patients with non-dialysis-dependent chronic kidney disease and iron deficiency anaemia. Methods In this randomized, open-label and multi-centre trial conducted in the USA, patients were randomized 2:1 to a single dose of 1000 mg IIM or iron sucrose (IS) administered as 200 mg IV injections up to five times within a 2-week period. The co-primary endpoints were serious or severe hypersensitivity reactions and change in haemoglobin (Hb) from baseline to Week 8. Secondary endpoints included incidence of composite cardiovascular adverse events (AEs). Results A total of 1538 patients were enrolled (mean estimated glomerular filtration rate 35.5 mL/min/1.73 m2). The co-primary safety objective was met based on no significant difference in the incidence of serious or severe hypersensitivity reactions in the IIM and IS groups [0.3% versus 0%; risk difference: 0.29% (95% confidence interval: –0.19; 0.77; P &gt; 0.05)]. Incidence of composite cardiovascular AEs was significantly lower in the IIM versus IS group (4.1% versus 6.9%; P = 0.025). Compared with IS, IIM led to a more pronounced increase in Hb during the first 4 weeks (P ≤ 0.021), and change in Hb to Week 8 showed non-inferiority, confirming that the co-primary efficacy objective was met. Conclusions Compared with multiple doses of IS, a single dose of IIM induced a non-inferior 8-week haematological response, comparably low rates of hypersensitivity reactions, and a significantly lower incidence of composite cardiovascular AEs.

A Head-to-Head Comparison of the Safety and Efficacy of Ferumoxytol to Iron Sucrose for the Treatment of Iron Deficiency Anemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5157-5157
Author(s):  
Allen Poma ◽  
Karen Diana ◽  
Justin McLaughlin ◽  
Annamaria Kausz
Keyword(s):  
Iron Deficiency ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Safety And Efficacy ◽  
Oral Iron Therapy ◽  
The Us ◽  
Iv Iron ◽  
Iron Replacement

Abstract Abstract 5157 BACKGROUND: Iron replacement therapy is essential for increasing iron stores and raising hemoglobin levels in patients with iron deficiency anemia (IDA). Oral iron supplements have limited absorption and are commonly associated with gastrointestinal (GI) side effects that reduce compliance, resulting in limited increases in hemoglobin. In patients without chronic kidney disease (CKD), oral iron therapy is frequently used to treat IDA. However, when oral iron therapy is unsatisfactory or cannot be tolerated, intravenous (IV) iron therapy may be appropriate. In the US, iron dextrans are the only approved IV iron products indicated for the treatment of IDA in non-CKD patients, and have limitations around convenience because they require a test dose and as many as 10 administrations via a slow infusion; iron dextrans have also been associated with a relatively high rate of serious adverse reactions compared to other IV iron products. Other IV irons, such as iron sucrose and sodium ferric gluconate, are only approved in the US for the treatment of IDA in patients with CKD. Like the iron dextrans, both of these products are limited by administration, requiring 5 to 10 clinic visits for the administration of a full therapeutic dose (1 gram of iron). Feraheme® (ferumoxytol) Injection is an IV iron product approved in the US for the treatment of IDA in adult subjects with CKD. Its carbohydrate coating is designed to minimize immunological sensitivity, and it has less free iron than other IV iron preparations. Ferumoxytol is administered as two IV injections of 510 mg (17 mL) 3 to 8 days apart for a total cumulative dose of 1.02 g. METHODS: To date, there have been a limited number of studies that have examined the safety and efficacy of IV irons in a head-to-head manner for the treatment of IDA, and no study has done so in a large number of subjects or in a broad patient population. AMAG, therefore, has initiated a randomized, controlled trial (ClinicalTrials.gov NCT01114204) to compare ferumoxytol with iron sucrose. Iron sucrose is approved in many countries outside the US for the treatment of IDA in patients intolerant to oral iron therapy, and is considered a safer alternative to IV iron dextran. This open-label trial (n=600) will evaluate the efficacy and safety of a 1.02 g of IV ferumoxytol, administered as 2 doses of 510 mg each, compared with 1.0 g of IV iron sucrose, administered as 5 doses of 200 mg each. Enrolled subjects will have IDA associated with a variety of underlying conditions including abnormal uterine bleeding, GI disorders, cancer, postpartum anemia, and others (eg, nutritional deficiency). Endpoints include changes in hemoglobin and transferrin saturation at Week 5, as well as evaluation of the requirement for erythropoiesis stimulating agent therapy and blood transfusion. Patient reported outcomes instruments will be employed to assess the impact of IV iron therapy on anemia symptoms and health-related quality of life (fatigue, energy, etc). Additionally, detailed information on healthcare utilization will be collected. CONCLUSION In the US, non-CKD patients with IDA who have a history of unsatisfactory oral iron therapy have limited options for iron replacement therapy. Study NCT01114204 will provide novel information comparing the safety and efficacy of two IV iron therapies for the treatment of IDA in a broad patient population. Disclosures: Poma: AMAG Pharmaceuticals, Inc.: Employment. Diana:AMAG Pharmaceuticals, Inc.: Employment. McLaughlin:AMAG Pharmaceuticals, Inc.: Employment. Kausz:AMAG Pharmaceuticals, Inc.: Employment.

scholarly journals Efficacy and Safety of Ferric Derisomaltose/Iron Isomaltoside in Patients with Inflammatory Bowel Disease: A Systematic Review

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4155-4155
Author(s):  
Keren Sam ◽  
Atif Irfan Khan ◽  
Anam Khan ◽  
Sobia Aamir ◽  
Fatima Sajid ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Adverse Events ◽  
Serum Ferritin ◽  
Bowel Disease ◽  
Research Funding ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Anemia in inflammatory bowel disease (IBD) presents as a common extraintestinal manifestation resulting in many complications. This condition is often missed or underrated, anemia is secondary to blood loss or defective absorption of iron which can result in a combination of iron deficiency anemia (IDA) or anemia of chronic disease (ACD). The management is iron replacement therapy which improves the quality of life in these patients. Due to the constraints in the use of oral iron, parenteral preparations are more used in IBD patients. Commonly used iron sucrose and ferric carboxymaltose are often associated with side effects leading to poor compliance. Our study explores data about ferric derisomaltose also known as iron isomaltoside (IIM), a recently approved IV iron preparation. The FDA approved this drug in 2020 for patients with poor compliance with other iron preparations. We explored the efficacy and safety data of ferric derisomaltose in adult patients with IBD. Material/Methods A literature search was performed using the following databases: PubMed, Cochrane, Embase, Clinical trials.gov, and Web of Science. The search was completed without using any filter and we used the MeSH Terms for "anemia", "iron deficiency anemia", "inflammatory bowel disease", and "ferric compounds". A total of 1590 articles were screened, and we finally selected 2 trials and 2 observational studies. We followed the PRISMA guidelines for literature search and selection of studies. Case reports, preclinical trials, meta-analyses, and review articles were excluded. Trial and observational studies related to IBD were included. Results In total, 294 patients with anemia in inflammatory bowel disease received ferric derisomaltose intravenously as a single dose between 500 mg to 2000 mg. All patients were &gt;18 years of age. The mean pre-treatment hemoglobin (Hb) level varied from 10.0 g/dL to 12.3 g/dL. The mean serum ferritin ranged from 19.6 µg/L to 57 µg/L and the mean transferrin saturation (TSAT) ranged from 8.8% to 18.5%. J. Stein et al investigated the effectiveness and safety of IIM in routine practical care of IDA in IBD patients. Dahlerup et al (NCT01599702) compared single dose IIM with multiple dosages of IIM in IBD patients. The remaining two studies investigated the effectiveness and safety of high dose IIM in patients with IBD. Results are summarized in Table 1. Efficacy: The increase in hemoglobin ranged from 0.6 g/dl to 2.9 g/dl from baseline while the increase in serum ferritin ranged between 102 µg /L to 250 µg /L and transferrin saturation increased in the range of 15.0%-23.7% in 10 to 52 weeks post iron isomaltoside (IIM) therapy. All markers of iron deficiency anemia showed significant improvement. In the observational study by J. Stein et al, the hemoglobin increased from a mean of 10.7 g/dl to 13.1 g/dl, serum ferritin increased from 57 µg /L to 146 µg /L, and TSAT from 8.8% to 23.7% at 16 weeks. Dahlerup et al demonstrated a Hb increase of &gt;2 g/dl in 75% of patients at 10 weeks. According to W. Reinisch et al (NCT 01410435), there was a mean increase in serum ferritin from 32 µg /L to 102 µg /L and a decrease in TSAT from the baseline, but this decrease was not statistically significant. Safety: Adverse events were noted in 8 (3.6%) patients. Out of the 8 patients, 4 (&lt;2%) were serious adverse events such as perianal abscess, miliary tuberculosis, nephrolithiasis, and worsening of ulcerative colitis, which may not be related to the study drug. The other 4 (1.8%) had life-threatening events, anaphylaxis being the most common. All four patients recovered. The most common mild adverse events reported were hypersensitivity reaction (HSR) seen in 3 patients. 2 patients discontinued due to mild HSR. There were no reports of death due to side effects of the drug. Conclusion Ferric derisomaltose has demonstrated a substantial increment in iron parameters in anemia in patients with IBD. This was measured in terms of hemoglobin response, serum ferritin, and transferrin saturation. Greater Hb response was achieved irrespective of concomitant treatment with steroids and anti-TGF-ß.The adverse events were mild, and patients recovered showing high compliance. Since the average duration of follow-up in our study was 21 weeks, long-term follow-up is limited for this drug, we need further studies to assess the need for maintenance therapy. Figure 1 Figure 1. Disclosures Anwer: GlaxoSmithKline: Research Funding; BMS / Celgene: Honoraria, Research Funding; Janssen pharmaceutical: Honoraria, Research Funding; Allogene Therapeutics: Research Funding.

scholarly journals A COMPARATIVE STUDY OF INTRAVENOUS IRON SUCROSE VERSUS ORAL IRON THERAPY IN IRON DEFICIENCY ANEMIA DURING POSTPARTUM PERIOD

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Satish Kumar
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Intravenous Iron ◽  
Hemoglobin Level ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Iron Group ◽  
Iv Iron

Introduction: Anemia is the commonest major contributing factor in maternal mortality and morbidity in developing countries and according to World Health Organization (WHO) criteria, it contributes to 20% of maternal deaths. Anemia in pregnancy defined as hemoglobin level <11 gm/dl (7.45 mmol/L) and hematocrit less than 33% (WHO). Aim: To compare the efficacy of oral iron ferrous sulphate therapy with intravenous iron sucrose therapy in the treatment of iron deficiency anemia during postpartum period. Material & Methods: This was a prospective randomized comparative clinical trial single center study conducted on 200 postpartum women aged >18 years (after normal delivery or LSCS) within 10 days of delivery with Hb level more or equal to 6 gm/dl but less than 10 gm/dl were included in the study. This was a one year study conducted during 1st December 2018 to 30th November 2019. Results : There was a significant increase in the hemoglobin level in both the groups i.e. in IV iron group, from 8.26 ±1.03gm/dl on day 1 to 11.62±0.94gm/dl on day 45 as compared to oral iron group, from 8.24±1.09gm/dl on day 1 to 11.07±1.14gm/dl on day 45; and serum ferritin level from 41.69±40.45ng/ml on day 1 to 77.34±41.60ng/ml on day 45 in IV iron group as compared to the oral iron group from 22.20±8.82ng/ml on day 1 to 31.72±9.72 ng/ml on day 45. So, there was a rapid increase in both hemoglobin and serum ferritin levels in IV iron group as compared to the oral iron group. Conclusion: Intravenous iron sucrose administration increases the hemoglobin level and serum ferritin more rapidly in compare to the oral intake of ferrous sulphate in women with iron deficiency anemia in postpartum women in our study. Keywords: Iron deficiency anemia, Intravenous iron sucrose, Serum ferritin, Maternal mortality.

scholarly journals Experience of a Single Latin-American Institution Using a Colloidal Iron Oxide Coated with a Semisynthetic Carbohydrate (ferumoxytol) for Iron Deficiency Anemia (IDA) in Patients with Intolerance or Treatment Failure with Oral Iron

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4887-4887
Author(s):  
Roberto Ovilla ◽  
Dannia Calles-Payan ◽  
Lucia A Reynolds-Ocampo ◽  
Gabriela Ruiz-Reyes ◽  
Carolina Balderas-Delgado ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Adverse Effects ◽  
Iron Deficiency Anemia ◽  
Latin American ◽  
Transferrin Saturation ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Number Of Patients ◽  
Initial Symptoms ◽  
The Mean

Abstract Tolerance to oral iron and low percentage of absorption in the gut has provoked the Iron Deficiency Anemia patients (IDA) fail to treatment or they have symptoms of anemia even more than 12 weeks until recovery. Intravenous iron is an alternative to minimize risk and treatment-related adverse effects and maximize profits in the short and long term. The number of patients who have access to ferumoxytol is reduced in developing countries, therefore experience in the treatment with this type of iron is limited. Patients received ferumoxytol 1020mg (two 510mg 8 days apart) and the response at 4 weeks of treatment by raising hemoglobin and clinical response was evaluated without transfusion support. From a total of 30 patients 76.6% (19) were women of whom 36.8% (7) were postmenopausal. The average age was 45.3 years (range 21-76 years). Before starting treatment, the mean serum iron, ferritin and rate of transferrin saturation was 35.6 mcg (range 8–174 mcg/dL), 13.8 ng/mL (range 1.6–60 ng/mL), 10.8% (range 2-58%) respectively. The mean initial hemoglobin was 10.5 g / dL (range 7.1-13.7g/dL), reaching an average of 13.03 g dL (range 9.4 - 16 _g/dL) at 4 weeks, raising 2.52 g dL (0.3 - 5.4g / _ g/dL) in 28 days. The percentage of patients who achieved an increase of > 2 g/dL of hemoglobin was 70% (21). The initial symptoms attributed to anemia disappeared in 66.6% within the first 2 weeks and the rest in 4-5 weeks. Adverse effects more frequently than 2%: fatigue 16.6% (5), headache 10% (3), nausea and dizziness 10% (3), peripheral edema 6.6% (2) and hypersensitivity 3.3% (1). All previous were easily controlled with medications. Despite the low number of patients treated due to the difficult accessibility of the drug in our population, ferumoxytol was shown to be an attractive option that rapidly improves symptoms with a satisfactory safety profile. Disclosures No relevant conflicts of interest to declare.

scholarly journals Plasma and Erythrocyte Folate in Iron Deficiency and Folate Deficiency

Blood ◽  
1970 ◽  
Vol 35 (6) ◽  
pp. 821-828 ◽  
Author(s):  
A. OMER ◽  
N. D. C. FINLAYSON ◽  
D. J. C. SHEARMAN ◽  
R. R. SAMSON ◽  
R. H. GIRDWOOD
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Megaloblastic Anemia ◽  
Folate Deficiency ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Plasma Folate ◽  
Erythrocyte Folate ◽  
The Mean ◽  
Anemia Group

Abstract Erythrocyte and plasma folate levels were studied before treatment in 20 patients with iron deficiency anemia and in 23 patients with megaloblastic anemia due to folate deficiency. Fourteen of the cases of iron deficiency anemia were also studied after treatment with oral iron alone. Fifty-seven normal persons were used as controls. The mean erythrocyte folate (ng./ml. packed cells) was significantly increased in iron deficiency anemia and significantly depressed in folate deficiency anemia. After treatment with oral iron alone, the mean erythrocyte folate level fell to normal in the iron deficiency anemia group. The mean corpuscular folate (ng. x 108-8) was also significantly raised in iron deficiency: in eight of 10 cases this fell after treatment, but the overall fall was not significant. The plasma folate rose in iron deficiency anemia after oral iron treatment.

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