scholarly journals Target Hemoglobin May Be Achieved with Intravenous Iron Alone in Anemic Patients with Cardiorenal Syndrome: An Observational Study

2015 ◽  
Vol 5 (4) ◽  
pp. 246-253 ◽  
Author(s):  
Eyal Ben-Assa ◽  
Yacov Shacham ◽  
Moshe Shashar ◽  
Eran Leshem-Rubinow ◽  
Amir Gal-Oz ◽  
...  
Keyword(s):  
Platelet Count ◽  
Adverse Effects ◽  
Observational Study ◽  
Treatment Strategy ◽  
Intravenous Iron ◽  
Cardiorenal Syndrome ◽  
Combination Group ◽  
Iron Treatment ◽  
Significant Difference ◽  
Iv Iron

Background: The treatment of anemia in patients with cardiorenal syndrome (CRS) is based mainly on intravenous (IV) iron therapy and/or erythropoiesis-stimulating agents (ESAs). There are concerns about the safety of ESAs due to a potentially higher risk for stroke and malignancy. Objective: We aimed to explore whether IV iron alone is sufficient to improve anemia in CRS patients and to define the predictors of treatment response. Methods: We retrospectively analyzed data of 81 CRS patient treated for anemia at our clinic. All patients received IV iron for 6 weeks. A subset of patients was additionally given subcutaneous ESAs. The end point was the improvement from baseline in hemoglobin (Hb) and ferritin levels at week 7. Results: We retrieved the files of 81 patients; 34 received IV iron alone and 47 were given IV iron and ESAs (the combination group). The Hb levels significantly increased in both groups (in the IV iron alone group: 10.6 ± 1.1 to 11.9 ±1.1 g/dl, p < 0.001; in the combination group: 10.2 ± 0.9 to 12.4 ± 1.3 g/dl, p < 0.001), but more pronouncedly in the combination group (2.17 vs. 1.24 g/dl; p = 0.001). The platelet count decreased significantly in the IV iron alone group but was unchanged in the combination group. Eighty percent of patients attained a Hb target of 11 g/dl, with no significant difference between the two groups (73.5 vs. 85.1%; p = 0.197). Low baseline Hb was the only predictor of a favorable outcome to treatment. Conclusion: Our observational study suggests that IV iron treatment without ESAs may substantially raise the Hb level to ≥11 g/dl in CRS patients. This treatment strategy may reduce the use of ESAs and hence its potential adverse effects.

scholarly journals P0858A MULTICENTRE PROSPECTIVE DOUBLE BLIND RANDOMISED CONTROLLED TRIAL OF INTRAVENOUS IRON IN IRON DEFICIENT BUT NOT ANAEMIC PATIENTS WITH CHRONIC KIDNEY DISEASE ON FUNCTIONAL STATUS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Xenophon Kassianides ◽  
Ahmed Ziedan ◽  
Victoria Allgar ◽  
Archie Lamplugh ◽  
Philip A Kalra ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Functional Status ◽  
Exercise Capacity ◽  
Heart Function ◽  
Intravenous Iron ◽  
The Body ◽  
Multi Centre Study ◽  
Iron Deficient ◽  
Significant Difference ◽  
Iv Iron

Abstract Background and Aims Iron deficiency is common in patients with CKD due to inadequate dietary intake of iron, poor iron absorption from the gut, and increased iron losses from the body. In addition to preventing anaemia, iron is also important for normal heart function, being involved in processes that generate a necessary continuous energy supply. Post hoc analysis of studies of people with iron deficiency and advanced CKD suggest treatment with intravenous iron leads to improvement in heart function and feeling of wellbeing. The aim of the study was to investigate whether intravenous (IV) iron could improve exercise capacity in comparison to placebo over 3 months in non-anaemic CKD patients who have iron deficiency. Method The Iron and the Heart Study was a prospective double blinded explorative randomized, multi-centre study designed to assess the effect of IV iron supplementation (ferric derisomaltose/iron isomaltoside 1000 (FDI); Monofer®) in iron deficient but not anaemic patients with advanced CKD on functional status. Adults with established CKD stages 3b-5 and serum ferritin (SF) &lt; 100mcg/L and/or transferrin saturation (TS) &lt;20% were randomized in a 1:1 ratio to 1000 mg IV FDI or placebo solution. Each participant was followed up at months 1 and 3. The primary outcome was the difference in exercise capacity using the 6-minute walk test (6MWT) at 3 months. Secondary objectives included effects on haematinic profiles and haemoglobin (Hb) concentrations. Results are given as mean and standard deviations (SD). Data was analysed using ANCOVA adjusted for baseline. Results Between October 2016 and April 2018, 54 individuals from 3 UK centres were randomized to FDI (n=26; mean age 61.6 (10.1) years) or placebo (n=28; mean age 57.8 (12.9) years). Mean serum creatinine (167.0 (40.2) vs. 204.9 (67.3) and eGFR (32.1 (9.6) vs. 29.1 (9.6)) at baseline were similar in FDI and placebo groups respectively. Adjusting for baseline 6MWT, the 6MWT at 1-month showed no statistically significant difference between groups (p=0.736) (Figure), and no significant difference at 3 months (p=0.741). The absolute mean change from baseline to 1 month and 3 months, showed no statistically significant differences between group (p=0.952_, p=0.895). There was no statistically significant difference between groups in Hb at 3-months (p=0.152) but there were statistically significant differences in SF and TS, which both increased post FDI infusion at 1 and 3 months; p&lt;0.001 (Table). Conclusion The Iron and the Heart Trial showed a significant increase in iron parameters and maintenance of Hb concentration in iron treated patients. There was a numerical increase in functional capacity at 1-month and to lesser extent at 3 months post iron infusion. This finding was not significant, which reflects the limited sample size and possible differences in population during randomisation with the large difference in 6MWT at baseline. A larger study will be required to demonstrate a possible short-term functional benefit on exercise capacity of IV iron in CKD patients with biochemical functional or absolute iron deficiency without anaemia.

Evaluation of Adherence, Virology and Imunology Response in HIV Patients Treated with a Once Daily Fixed Dose Combination (FDC) and a Free Combination of Antiretroviral

2018 ◽  
Vol 24 (8) ◽  
pp. 6143-6146
Author(s):  
N Mariana ◽  
V Lisdawati ◽  
S Maemun ◽  
A Sucahyo ◽  
P Debby ◽  
...  
Keyword(s):  
Viral Load ◽  
Treatment Group ◽  
Treatment Strategy ◽  
Fixed Dose ◽  
Combination Group ◽  
Similar Proportion ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Once Daily ◽  
Significant Difference

A once daily FDC is a treatment strategy to reduce both the pill burden and the dosing frequency. This study to evaluate the adherence, virology and immunology response in patients treated with a once daily FDC (single pill) and free combination of antiretroviral (more than one pill). A cross sectional study on adults HIV–infected (aged >18 years old) in Sulianti Saroso Hospital, ARV–naïve patients for 12 months of treatment, receiving the first line ARV bases on Tenovofir and Efavirenz in the form of once daily FDC and a free combination of ARV. Ninety eight patients (a once daily FDC group consist of 78 patients and a free combination group consist of 20 patients) were recruited during the period of July to October 2017. The proportion of patients with good adherence (≥95%) after 12 months of once daily FDC treatment group was 98,7%, and a free combination group was 100%. The proportion of patients with an undetectable viral load to a once daily FDC treatment group was 80%, and a free combination group was 85,5%. The viral load and adherence were not significantly different statistically in two groups (Fisher Exact, p value >0,05) at 12 months of treatment and there was no significant difference in the increase in CD4 cell count at 6 months between those 2 groups at 6 months of treatment (Chi-Square p = 0,723). A once daily FDC treatment strategy and a free combination of ARV have the same benefits toward adherence, immunology response at 6 months therapy and virology response in HIV patients during 12 months of therapy. Confirmatory studies with similar proportion of patients between the two groups are needed to clarify the benefits of adherence, immunology and virology response.

scholarly journals A cross sectional observational study to find the difference in occurrence of muscle related adverse effects of statins among geriatric and non-geriatric patients

2018 ◽  
Vol 7 (9) ◽  
pp. 1817
Author(s):  
Monica Aggarwal ◽  
Shivani Juneja ◽  
Muskan Goyal ◽  
Tariq Khurana
Keyword(s):  
Adverse Effects ◽  
Observational Study ◽  
Older People ◽  
Patient Information ◽  
Geriatric Patients ◽  
Creatine Phosphokinase ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference ◽  
The Difference

Background: Statins are effectively used for the treatment of dyslipidemias in geriatric patients. The geriatric patients are more vulnerable to experience consequences of drug intensification leading to the manifestation of adverse effects, such as muscle related adverse effects (MRAE) with statins use. The main objective was to find the difference in the occurrence of MRAE of statins among geriatric and non-geriatric users.Methods: This was a cross-sectional, observational comparative study in which MRAE associated with statins and relevant patient information was noted. Creatine phosphokinase (CPK) levels which are considered as a marker for statin induced muscle damage were obtained for all patients. The different parameters were compared among geriatric and non-geriatric statin users.Results: Sixty one patients, 28 geriatric (≥60 years) and 33 non-geriatric (<60 years) statin users were enrolled in this study. Ten (38%) geriatric statin users as compared to 6 (20%) non-geriatric statin users were found to have MRAE (P = 0.207). No significant difference in the occurrence of MRAE among geriatric and non-geriatric statin users was found.Conclusions: The results obtained from the present study suggest that statins are relatively safe, even in older people. There was no evidence to suggest an increased risk of MRAE in geriatric patients receiving statin therapy as compared to non- geriatric patients.

Concerns and Side Effects of Azathioprine During Adalimumab Induction and Maintenance Therapy for Japanese Patients With Crohn’s Disease: A Subanalysis of a Prospective Randomised Clinical Trial [DIAMOND Study]

2019 ◽  
Vol 13 (9) ◽  
pp. 1097-1104 ◽  
Author(s):  
Tadakazu Hisamatsu ◽  
Takayuki Matsumoto ◽  
Kenji Watanabe ◽  
Hiroshi Nakase ◽  
Satoshi Motoya ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Side Effects ◽  
Crohn's Disease ◽  
Adverse Effects ◽  
Multivariable Analysis ◽  
Dropout Rate ◽  
Rank Test ◽  
Combination Group ◽  
Monotherapy Group ◽  
Significant Difference

Abstract Background Combining a thiopurine with the human anti-tumour necrosis factor-α monoclonal antibody adalimumab for Crohn’s disease [CD] treatment is controversial with regard to efficacy and safety. By conducting a subanalysis of a multicentre, randomised, prospective, open-label trial [the DIAMOND study, UMIN registration number 000005146], we studied the risk of discontinuation of thiopurine in combination with adalimumab. Methods In the preceding DIAMOND study, we analysed the: [i] timing and reasons for dropout in the monotherapy group and combination group; [ii] risk factors for dropout in the combination group. Results There was no significant difference in the dropout rate up to Week 52 between the monotherapy group and combination group [p = 0.325]. The main reason for study dropout was active CD in the monotherapy group, whereas it was adverse effects in the combination group [Fisher’s exact test, p <0.001]. Kaplan–Meier analyses revealed significantly earlier dropout in the combination group [log-rank test, p = 0.001]. Multivariable analysis revealed low body weight to be a risk for dropout due to adverse effects in the combination group. Conclusions Combination of azathioprine with adalimumab resulted in dropout in the early stage of the study due to side effects of azathioprine, in comparison with late dropout due to active CD in the adalimumab monotherapy group.

scholarly journals Hemostatic alterations in patients with obstructive sleep apnea: an observational study

2019 ◽  
Vol 5 (4) ◽  
pp. 990
Author(s):  
Basavaraj P. Belaldavar ◽  
Tejaswini J. S. ◽  
Samanvaya Soni
Keyword(s):  
Platelet Count ◽  
Observational Study ◽  
Prothrombin Time ◽  
Bleeding Time ◽  
Treatment Options ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Level I

<p class="abstract"><strong>Background:</strong> Obstructive sleep apnoea (OSA) is characterized by repetitive partial or complete collapse of the upper airway during sleep, which results in disruptions of normal sleep architecture. It is associated with cardiopulmonary consequences like hypertension, myocardial infarction and stroke. Although the pathogenesis of this association remains unclear, an alteration in coagulability is suspected as a linkage. Hence, the present study aims at the reliability of Bleeding time, platelet count, PT, aPTT and INR to assess the effect on OSA patients’ cardiovascular system.</p><p class="abstract"><strong>Methods:</strong> This is an observational study done on 32 individuals diagnosed with OSA after level I polysomnography from time period of January 01, 2018 to December 31, 2018. The blood coagulation parameters studied for each individual were platelet count, bleeding time (BT), activated partial thromboplastin time (aPTT) and prothrombin time (PT/INR).</p><p class="abstract"><strong>Results:</strong> Out of a total 32 subjects, 17 (53.13%) were male and 15 (46.87%) were female. There is a significant difference in mean prothrombin time (p=0.022). Kruskal-Wallis test showed a significant difference in the median of the PT/INR (p=0.01) and AHI (p&lt;0.001) for different categories of OSA. Prothrombin time is the only factor which is affecting the OSA.</p><p class="abstract"><strong>Conclusions:</strong> Patients with severe OSA may have elevated coagulability levels, particularly in the length of prothrombin time. The potential for anticoagulant and antiplatelet medications to reduce mortality in patients with OSA merits exploration, particularly for patients who are unwilling or unable to achieve full control of OSA with currently available treatment options.</p>

scholarly journals P350 SAFIIR: Study of Anemia Following Intravenous Iron Repletion

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S371-S372
Author(s):  
L C Rioux ◽  
E J Bernard ◽  
M Bourgault ◽  
P Mondragon ◽  
V Rioux
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Saturation ◽  
Real Life ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
The Real ◽  
Iron Treatment ◽  
Life Impact ◽  
Iv Iron

Abstract Background The main objective of this study was to assess the prevalence of anemia and the secondary objectives aimed to evaluate the real-life impact of intravenous iron therapy on anemia correction in patients living with Inflammatory Bowel Disease (IBD). Methods We performed a retrospective cohort study of adult patients (18 to 80 years old) with a Crohn’s Disease or Ulcerative Colitis diagnosis who were followed at our clinic between January 2018 and March 2020. Clinical data were obtained from the patients’ electronic medical records. Iron-deficiency anemia was defined as hemoglobin (Hb) &lt; 12,0 g/dL and/or transferrin saturation (TSAT)&lt; 20 % and/or low serum iron (≤ 10 μmol/L). Intravenous (IV) iron treatment was defined as at least one infusion of iron isomaltoside, iron sucrose, or sodium ferric gluconate. The secondary analyses were performed in terms of IV iron treatments. Results Of the cohort of 556 IBD patients, 223 (40.1%) had an anemia diagnosis. Among the latter, 39 patients received an intravenous iron treatment and had laboratory results in the 8 weeks preceding and in the 8 weeks following the treatment. Table 1 shows the response to intravenous iron treatment in patients with baseline Hb &lt; 12,0 g/dL (n=28 patients, 47 IV iron infusions). Table 2 shows the changes in anemia-related laboratory values in the 8 weeks preceding and in the 8 weeks following intravenous iron treatment. Conclusion This was the first study to evaluate the prevalence of iron-deficiency anemia and the real-life impact of intravenous iron treatment among patients living with IBD in Quebec, Canada. The findings will serve as a baseline for subsequent interventions to improve the wellbeing and the quality of life of IBD patients with anemia.

scholarly journals Intravenous Iron Infusions in Pediatric Patients: A Single Institution Assessment of Efficacy and Adverse Effects of IV Iron Infusions

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5872-5872
Author(s):  
Jennifer A Nestor ◽  
Faraz A Afridi ◽  
Richard Suarez ◽  
Joey Bou Karem ◽  
Michael Hardiman ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Adverse Effects ◽  
Iron Supplementation ◽  
Pediatric Patients ◽  
Intravenous Iron ◽  
Single Institution ◽  
Patient Demographics ◽  
Iv Iron ◽  
Pediatric Populations ◽  
The Mean

Background: Iron deficiency, even without a diagnosis of anemia, can be neurodevelopmentally dangerous in pediatric populations. Oral iron supplementation has been the treatment of choice but is associated with poor adherence for several reasons including metallic taste of the tablets, gastric irritation, severe constipation, and daily dosing for several weeks. Intravenous iron has been safely used in adult populations for iron supplementation, but has less commonly been used in pediatric populations. It is hypothesized that pediatric patients with iron deficiency anemia (IDA) who receive intravenous iron infusions will show normalization of hematologic parameters. Methods: EMR of patients aged 1-21 who received at least one intravenous iron infusion at Cooper University Hospital between 2016 and January 2019 were reviewed for retrospective data collection. Pre-infusion lab values including Hgb, MCV, RBCs and RDW were compared to post-infusion values to determine if values normalized after intravenous iron infusion. Patient demographics including ethnicity, cause of IDA, prior oral iron treatments, and adverse effects of oral and IV iron were analyzed. Results: There were 33 subjects in this study. The average age of the subjects was 12.8 (+/- 5.1) years of age and 79% were female. The most prevalent indication for IV iron was menorrhagia (55%), while GI issues were 18% and insufficient diet accounted for 27%. The mean baseline HGB was 8.3 (+/- 1.7) while the mean final HGB increased to 11.5 (+/- 1.4) (p<0.001). The mean baseline MCV was 69.2 (+/- 9.3) and the mean last MCV was 76.1 (+/- 6.8) (p<0.001). The mean baseline RBC was 4.2 (+/- 0.82) and the mean last RBC was 4.9 (+/- 0.6) (p<0.001). Conclusion: IV iron sucrose infusions administered to pediatric outpatients were safe and effective in children and adolescents with IDA. Adherence to intravenous iron did not significantly improve. Hematologic parameters improved with infusions. Further analysis of patient demographics and characteristics of diagnosis needs to be performed to elucidate benefits of this therapy. As a single institution study, the results are limited to a regional patient population and their specific demographics. Disclosures No relevant conflicts of interest to declare.

scholarly journals Intravenous iron therapy and circulating biomarkers of inflammation in men with heart failure with reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Drozd ◽  
M Tkaczyszyn ◽  
K Wegrzynowska-Teodorczyk ◽  
M Kasztura ◽  
M Dziegala ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intravenous Iron ◽  
Inflammatory Biomarkers ◽  
Iron Therapy ◽  
Reduced Ejection Fraction ◽  
Tnf Α ◽  
Inflammatory State ◽  
Iv Iron ◽  
Hs Crp ◽  
Intravenous Iron Therapy

Abstract Background Large randomized clinical trials have demonstrated that intravenous (IV) iron therapy in iron-deficient patients with heart failure with reduced ejection fraction (HFrEF) brings clinical benefits related to symptoms of the disease and exercise capacity. Mechanisms underlying beneficial effects of such repletion are still the subject of interest as this is not solely related to improved haematopoiesis (IV iron works also in non-anaemic subjects). In patients with chronic heart failure iron deficiency (ID) is linked with inflammatory processess but data regarding the impact of IV iron on inflammation is scarce. Purposes We evaluated whether IV iron therapy affects circulating biomarkers of pro-inflammatory state in men with HFrEF and concomitant ID. Methods This is the sub-analysis of the study to investigate the effects of IV ferric carboxymaltose (FCM) on the functioning of skeletal muscles in men with HFrEF. For the purposes of current research we analyzed data of 20 men with HFrEF (median age 68 (62, 75 – in brackets interquartile ranges, respectively) years, LVEF: 30 (25, 35) %, ischaemic HF aetiology: 85%, NYHA class I/II/III: 30%/50%/20%) and ID (definition according to ESC guidelines - ferritin &lt;100 ng/mL, or ferritin 100–299 ng/mL with transferrin saturation [TSAT] &lt;20%) who were randomized in a 1:1 ratio to receive either the 24-week therapy with IV FCM (dosing scheme as in the CONFIRM-HF trial) or saline (controls). The study was double-blinded. We used ELISA to evaluate different circulating pro-inflammatory biomarkers (high-sensitivity C-reactive protein [hs-CRP], tumor necrosis factor alpha [TNF-α], interleukin 6 [IL-6], interleukin 1 beta [IL-1β], interleukin 22 [IL-22]) at baseline and week 24. Results IV FCM therapy repleted iron stores in men with HFrEF as reflected by an increase in serum ferritin and TSAT, which was not seen in a control group. IV FCM therapy (as well as the saline administration) affected neither haemoglobin concentration nor parameters reflecting iron stores in red cells. Baseline serum ferritin was not related to hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 (all p&gt;0.23). Baseline TSAT was related to hs-CRP (r=−0.47, p=0.02) but not other inflammatory biomarkers. Levels of hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 at week 0 were similar in subjects who received IV iron and controls (all p&gt;0.22). Change from week 0 to week 24 adjusted for baseline value (delta W24-W0 as the percentage of W0) regarding IL-22 was lower in an active treatment arm as compared with saline (p=0.049) and there was a trend towards lower delta TNF-α in FCM group compared to saline (p=0.067). These findings were not valid for other measured pro-inflammatory biomarkers. Conclusions In men with HFrEF and concomitant ID intravenous iron therapy with FCM affects biomarkers of pro-inflammatory state. Clinical relevance of this finding requires further translational research. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This research was funded by the National Science Centre (Poland) grant allocated on the basis of the decision number DEC-2012/05/E/NZ5/00590

scholarly journals Intravenous iron is non-inferior to oral iron regarding cell growth and iron metabolism in colorectal cancer associated with iron-deficiency anaemia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hafid O. Al-Hassi ◽  
Oliver Ng ◽  
Rayko Evstatiev ◽  
Manel Mangalika ◽  
Natalie Worton ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Iron Deficiency ◽  
Iron Metabolism ◽  
Iron Deficiency Anaemia ◽  
Iron Transport ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Loading ◽  
Deficiency Anaemia ◽  
Iron Treatment

AbstractOral iron promotes intestinal tumourigenesis in animal models. In humans, expression of iron transport proteins are altered in colorectal cancer. This study examined whether the route of iron therapy alters iron transport and tumour growth. Colorectal adenocarcinoma patients with pre-operative iron deficiency anaemia received oral ferrous sulphate (n = 15), or intravenous ferric carboxymaltose (n = 15). Paired (normal and tumour tissues) samples were compared for expression of iron loading, iron transporters, proliferation, apoptosis and Wnt signalling using immunohistochemistry and RT-PCR. Iron loading was increased in tumour and distributed to the stroma in intravenous treatment and to the epithelium in oral treatment. Protein and mRNA expression of proliferation and iron transporters were increased in tumours compared to normal tissues but there were no significant differences between the treatment groups. However, intravenous iron treatment reduced ferritin mRNA levels in tumours and replenished body iron stores. Iron distribution to non-epithelial cells in intravenous iron suggests that iron is less bioavailable to tumour cells. Therefore, intravenous iron may be a better option in the treatment of colorectal cancer patients with iron deficiency anaemia due to its efficiency in replenishing iron levels while its effect on proliferation and iron metabolism is similar to that of oral iron treatment.

scholarly journals Safety and efficacy of a single total dose infusion (1020 mg) of ferumoxytol

2021 ◽  
Vol 12 ◽  
pp. 204062072110060
Author(s):  
Harris Khan ◽  
Paige May ◽  
Elim Kuo ◽  
Preetika Pai ◽  
Katherine Boles ◽  
...  
Keyword(s):  
Single Dose ◽  
Total Dose ◽  
Treatment Option ◽  
Deficiency Anemia ◽  
Utilization Review ◽  
Veterans Health ◽  
Significant Difference ◽  
Dose Infusion ◽  
Iv Iron ◽  
The Impact

Purpose: Iron deficiency anemia (IDA) is the most common type of anemia. A single dose infusion of intravenous (IV) iron is a convenient treatment option. Ferumoxytol is an IV formulation of iron that is typically given in two doses of 510 mg each. Utilizing a single dose of 1020 mg over 15 min has previously been described as safe and effective. In July 2018, we began to administer a single 1020 mg dose of ferumoxytol to patients needing IV iron replacement at the North Florida/South Georgia Veterans Health System. To evaluate the impact of this change, a utilization review was conducted. Methods: Outcomes of all patients who received ferumoxytol injections in the 6 months prior to and after the dosing strategy change were analyzed. A total of 140 patients, who received 270 separate IV ferumoxytol infusions, were included in the analysis. Results: No significant difference in safety was observed, with one infusion reaction occurring in each group ( p = 1.00). Efficacy also appeared equivalent with no significant difference between the change in hemoglobin for those who received a single 1020 mg dose versus those who received two 510 mg doses ( p = 0.764). As expected, those who received a single total dose infusion of 1020 mg had less clinic utilization ( p < 0.0001). Conclusion: In summary, ferumoxytol administered as a 1020 mg single dose infusion was more convenient and should be considered a safe and effective treatment option for IDA.

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