Effect of High Static Magnetic Fields on Biological Activities and Iron Metabolism in MLO-Y4 Osteocyte-Like Cells

There are numerous studies that investigate the effects of static magnetic fields (SMFs) on osteoblasts and osteoclasts. However, although osteocytes are the most abundant cell type in bone tissue, there are few studies on the biological effects of osteocytes under magnetic fields. Iron is a necessary microelement that is involved in numerous life activities in cells. Studies have shown that high static magnetic fields (HiSMF) can regulate cellular iron metabolism. To illustrate the effect of HiSMF on activities of osteocytes, and whether iron is involved in this process, HiSMF of 16 tesla (T) was used, and the changes in cellular morphology, cytoskeleton, function-related protein expression, secretion of various cytokines, and iron metabolism in osteocytes under HiSMF were studied. In addition, the biological effects of HiSMF combined with iron preparation and iron chelator on osteocytes were also investigated. The results showed that HiSMF promoted cellular viability, decreased apoptosis, increased the fractal dimension of the cytoskeleton, altered the secretion of cytokines, and increased iron levels in osteocytes. Moreover, it was found that the biological effects of osteocytes under HiSMF are attenuated or enhanced by treatment with a certain concentration of iron. These data suggest that HiSMF-regulated cellular iron metabolism may be involved in altering the biological effects of osteocytes under HiSMF exposure.

Current views on the pharmacological correction of iron deficiency conditions in gynecological practice

The review considers features of iron and folic acid (FA) pharmacokinetics, which affect the effective micronutrient support: molecular mechanisms of absorption and distribution, homeostatic processes of maintaining plasma vitamin and mineral levels by the feedback mechanism, including by regulating the deposition. An important characteristic of ferrokinetics is the presence of unique iron exporter ferroportin which is controlled by a family of iron regulatory proteins. Systemic ferrotherapy and oral rout of iron delivery are distinguished. In general, parenteral iron preparation complexes consist of Fe(III) oxide/hydroxide core stabilized by a carbohydrate polymer shell. Once entering the bloodstream, iron complexes are absorbed by resident macrophages of the reticuloendothelial system of the liver, spleen and bone marrow. Systemic Fe(III) preparations are prodrugs, the active part of which, i.e. iron is released in the lysosomal matrix of phagocytes. Oral iron preparations are divided into those containing bivalent (ferrous) and trivalent (ferric) iron. The article discusses factors determining the differences in the absorption of oral ferrous and ferric iron preparation, the spectrum of side effects, as well as key pharmaceutical approaches to increase the tolerance and adherence of ferrotherapy. These include using preparations containing Fe(II) organic compounds that have a lower dissociation rate than inorganic iron salts as well as slowing down the release of the active Fe(II) pharmaceutical substance from the drug. The review pays special attention to folates as iron synergists and examines the features of FA pharmacokinetics, the molecular basis of synergism, and substantiates the use of combined iron and FA preparations.

Analysis of economic efficiency of iron deficiency anemia therapy in patients with malignant tumors

Introduction. Correction of iron deficiency anemia in patients with malignant neoplasms is an important aspect affecting the quality of life and the effectiveness of special treatments. At the same time, the therapy of comorbid conditions significantly increases the cost of treating cancer patients.The aim of the study was to conduct a comparative pharmacoeconomic analysis of the two most common methods for correcting iron deficiency anemia in cancer patients: transfusion of erythrocyte suspension and intravenous iron preparations using iron carboxymaltose as an example.Materials and methods. An observational, analytical, cohort study was carried out, which included 120 cancer patients. The patients underwent laboratory examination. The tests were assessed: a general blood test with an assessment of the morphological characteristics of erythrocytes, serum iron, ferritin, CRP, total protein. An analysis of the costs of iron deficiency anemia therapy was carried out, taking into account the procurement cost of drugs.Results. It is economically more profitable to use intravenous iron preparations in comparison with transfusion of erythrocyte suspension for the treatment of iron deficiency anemia in patients with malignant neoplasms. The cost of correcting iron deficiency anemia per patient was: when treated with carboxymaltosate iron (Ferinject): 7943.96 rubles, with transfusion of erythrocyte suspension: 16856.40 rubles.Conclusion. In the treatment of anemia in patients with malignant neoplasms with blood preparations (erythrocyte suspension), an improvement in hematological parameters is noted earlier and to a greater extent than with the use of iron preparation carboxymaltozate («Ferinject»). Nevertheless, the duration of the clinical effect when using erythrocyte suspension is lower than that of a parenteral iron preparation.

Conversion of haemodialysis patients from iron sucrose to iron isomaltoside: a real-world experience

Background Anaemia is common in haemodialysis (HD) patients and associated with significant morbidity and mortality. Intravenous (IV) iron combined with erythropoiesis-stimulating agents (ESA) is the mainstay treatment of anaemia in these patients. The comparative efficacy and risk of adverse events with IV iron preparations have been assessed in only a few trials. Methods This was a retrospective observational study in 2 centres designed to compare the safety and efficacy of iron sucrose (IS-Venofer®) versus iron isomaltoside (IIM-Diafer®) in haemodialysis patients. The study included patients currently on dialysis and receiving Venofer who were switched to Diafer® and monitored for at least 12 months for each iron preparation. Results A total of 190 patients were included and had a mean age of 65.8 years (SD ± 15.5). Non-inferiority was confirmed with no change in mean haemoglobin per mg of iron administered over a 12-month period. In total there were 41,295 prescriptions of iron isomaltoside and 14,685 of iron sucrose with no difference in the number of reported adverse events during the study period (7 each, none were severe). There was a statistically significant effect on Hb over time after conversion, including after adjustment for multiple comparisons. There were significant improvements in ferritin over time, which remained at 6 months (P<0.01). The weekly iron dose was similar after adjustment (P=0.02). The EPO dose did not differ significantly after month 0 in patients switched to IIM. Conclusions This study demonstrates the comparative safety and efficacy of iron isomaltoside versus iron sucrose, with similar dosing schedules in dialysis patients. Iron isomaltoside is non-inferior to iron sucrose in maintaining Hb in patients on regular haemodialysis/haemodiafiltration with no difference in the number of reported adverse events.

Conversion of haemodialysis patients from iron sucrose to iron isomaltoside: a real-world experience

Background Anaemia is common in haemodialysis (HD) patients and associated with significant morbidity and mortality. Intravenous (IV) iron combined with erythropoietin (EPO) is the mainstay treatment of anaemia in these patients. The comparative efficacy and risk of adverse events with IV iron preparations have been assessed in only a few trials. Methods This was an observational longitudinal repeated measures retrospective study designed to compare the safety and efficacy of iron sucrose (IS-Venofer®) versus iron isomaltoside (IIM-Diafer®) in haemodialysis patients. The study included patients currently on dialysis and receiving Venofer who were switched to Diafer and monitored for at least 12 months for each iron preparation. Results A total of 190 patients were included and had a mean age of 65.8 years. Non-inferiority was confirmed with no change in mean haemoglobin per mg of iron administered over a 12-month period. In total there were 41,295 prescriptions of iron isomaltoside and 14,685 of iron sucrose with no difference in the reported adverse events during the study period (7 each, none were severe). There was a statistically significant effect on Hb over time after converting (T0), including after adjustment for multiple comparisons. There were significant improvements in ferritin over time, which remained at 6 months (P<0.01). The weekly iron dose was similar after adjustment (P=0.02). The EPO dose did not differ significantly after month 0 in patients switched to IIM. Conclusions This study demonstrates the comparative safety and efficacy of iron isomaltoside versus iron sucrose, with similar dosing schedules in dialysis patients., with no differential impact on Hb, and ferritin which were maintained at satisfactory levels for at least 12 months. There was no difference in reported adverse events.

Toxicological evaluation of a new iron-containing preparation for farm animals with alimentary anemia

The second for the significance livestock sector is pig breeding, which accounts for one-third of the country’s meat production. Long-term world practice of pig farming confirms the high maturity of this species of animals, excellent taste, nutritious meat and most importantly the ability to quickly increase food production, and thereby ensure the optimal balance of the diet of the population. One of the constraining factors for the development of this industry is the development of iron deficiency alimentary anemia in pigs during the first 7 days of animal life, which affects the growth, development and increase of live weight in animals. Without preventive measures to supplement the iron with animals, up to 100% of piglets become sick with anemia, which can lead to the death of a significant part of the young population. This article presents the results of the toxicological approbation of a new iron-containing preparation for farm animals. The question of finding a less toxic iron preparation with a higher prolonging effect is relevant.

Peroral retard iron preparation for iron-deficiency anemia: case study and pharmacoeconomic analysis

Iron-deficiency anemia (IDA) is an important issue. The prevalence of IDA in women of reproductive age and women in perimenopause is high and has no tendency to reduce. Pharmacoeconomic aspects and recent data on clinical efficacy of iron supplements for obstetrical gy-necological disorders are addressed. The authors review international and domestic published data on iron supplements prescribed in women with obstetrical gynecological diseases. The paper describes the results of cost-effectiveness analysis and clinical trials published earlier that compare the efficacy of the treatment with iron supplements in women who experienced IDA or gynecological disorders complicated by iron deficiency during the pregnancy. One of the bivalent iron retard preparations, Tardyferon®, is discussed. In addition, Tardyferon® is compared with similar iron supplements and Fe(III)-hydroxide-polymaltose complex. Pharmacoeconomic utility of bivalent iron preparation from the viewpoint of the patient and the doctor is validated.Keywords: pharmacoeconomic analysis, iron deficiency, iron-deficiency anemia, pregnancy, iron supplements, bivalent iron.For citation: Dobrokhotova Yu.E., Markova E.A. Peroral retard iron preparation for iron-deficiency anemia: case study and pharmacoecono-mic analysis. Russian Journal of Woman and Child Health. 2020;3(2):88–94. DOI: 10.32364/2618-8430-2020-3-2-88-94.

Severe hypophosphataemia following ferric carboxymaltose infusion in paediatric patients with inflammatory bowel disease

This case series describes the cases of three adolescent patients with established inflammatory bowel disease (IBD) who experienced significant hypophosphataemia following intravenous infusion of ferric carboxymaltose as treatment for iron deficiency anaemia. Hypophosphataemia may cause a diverse range of symptoms and may be difficult to diagnose clinically due to their non-specific nature. Checking a baseline phosphate (PO4) prior to intravenous iron infusion may identify patients at higher risk for significant hypophosphataemia and perhaps allow the selection of an alternative iron preparation. The routine monitoring of PO4 levels postinfusion presents a greater challenge; with cases of asymptomatic hypophosphataemia likely to be uncovered, as in case 3. Clinicians, patients and families should be aware of the symptoms of hypophosphataemia, and symptomatic patients should have bloods checked to allow prompt identification and correction of abnormalities where required. Review of guidelines surrounding intravenous iron infusion and management of hypophosphataemia in paediatric patients is now required.