Ferric Carboxymaltose Injection In the Treatment of Postpartum Iron Deficiency Anemia
Keywords:
Ferric carboxymaltose, Iron deficiency anemia, Modified Ganzoni FormulaAbstract
Introduction: Iron deficiency anemia, defined by the WHO as haemoglobin (Hb) less than 12g/dL, is the most common cause of anemia in the postrpartum period with rates as high as 37% reported in the first postpartum week. Ferric carboxymaltose can be administered in single doses up to 1000mg over 15 minutes. Our study was designed to test the hypothesis that ferric carboxymaltose is superior to oral iron in the correction of postpartum iron deficiency anemia. Methods: this study was conducted at our tertiary care institute between June 2014 to December 2014. 100 Healthy women 10 days or less after delivery with postpartum anemia requiring Iron supplementation were enrolled. The subjects were randomized to receive ferric carboxymaltose (n50) or ferrous sulfate ( remaining 50)The dosage of ferric carboxymaltose was based on the calculated iron deficit using a modified Ganzoni formula. Ferric carboxymaltose was given weekly unit the individuals calculated cumulative dose had been reached or a maximum of 2500 mg of ferric carboxymaltose had been administered. Results: In both the study and safety populations, mean study drug usage and the percentage of subjects who received 67% or greater of study drug were comparable between treatment groups, averaging 96% or greater. The percentage of subjects in the study who met the primary efficacy end point (hb greater than 12g/dL was significantly greater in the ferric carboxymaltose group than in the oral iron group (91.4 % vs 66.7%). Conclusion: Ferric carboxymaltose produced significantly greater and sustained increase in Hb in a significantly shorter period of time than full therapeutic doses of oral iron.
Downloads
References
Bodnar LM, Scanlon KS, Freedman DS, Siega-RizAM, Cogswell ME, High Prevalence of postpartum anemia among low income women in the United States. Am J Obstet Gyneco 2001; 185: 438-43.
Bodnar LM, Cogswell ME, McDonald T. Have we forgotten the significance of postpartum iron deficiency? Am J Obstet Gynecol 2005;193: 36-44.
Ahmed K, Saqid I, Yousuf AW, Injectable iron therapy: intramuscular vs. intravenous therapy. Biomedics 2000;16: 44-7.
Pernoll ML. Irondeficiency anemia.In: Pernoll ML (ed). Benson and Pernill’s handbook of obstetrics and gynecology 10th ed. Columbus (OH): The McGraw-Hill Companies, Inc; 2001.p. 435-7.
James A, Patel S, Dinh Q. Impact of anemia on medical resource utilization and hospital cost in women with obstetrical bleeding. Blood 2007; 110:5168.
Beard JL, Hendricks Mk, Perez EM, et al. Maternal iron deficiency anemia affects post-partum emotions and cognition. J Nutr 2005;135: 267-72.
Perez EM, Hendricks MK, Beard JL, et al. Mother-infant interactions and infant development are altered by maternal iron deficiency anemia. J Nutr 2005;135: 850-5.
Danielson BG, Geisser P, Schneider W [eds]. Iron therapy with special emphasis on intravenous administration. 1st ed. St. Gallen, Switzer-land: Vifor (international) Inc; 1996.
Bonnar J, Goldberg A, Smith JA. Do Preg-nant women take their iron? Lancet 1969; 1: 457-8.
Walter BA, Van Wyck DB. Benchmarking iron dextran sensitivity: reactions requiring resuscitative medication in incident and prevalent patient. Nephrol Dial Transplant 2005; 20: 1438-42.
Fishbane S, Ungureanu VD, maesaka JK, Kaupke CJ, Lim V, Wish J. The safety of intra-venous iron dextran in hemodialysis subjects. Am J Kidney Dis 1996; 28: 529-34.
Auerbach M, Chaudhry M, Goldman H, Bal-lard H. Value of methyl prednisolone in prevention of the arthralgia myalgia syndrome associated with the total dose infusion of iron dextran: A double blind randomized trial. J Lab Clin Med 1998; 131: 257-60.
Burns Dl, Mascioli EA, Bistrian BR. Parenteral iron dextran therapy: A review. Nutrition 1995;11: 163-8.
Chertow GM, Mason PD, Vaage- Nilsen O, Ahlmen J. Update on adverse drug events associated with parenteral iron. Nephrol dial Transplant 2006;21: 378-82.
Bhandal N, Russell R. Intravenous versus oral iron therapy for postpartum anaemia. BJOG 2006;113: 1248-52.
Dede A, Uygur D, Yilmaz B, Mungan T, Ug ur M. Intavenous iron sucrose complex vs. Oral ferrous sulfate for postpartum iron deficiency anemia. Int J Gynaecol Obstet 2005;90: 238-9.
Ferrlecit prescribing information. Corona (CA): Watson Pharma Inc; 2006.
Venofer prescribing information. Shirley (NY): American Regent Inc; 2007.
AndrewsN, BreymanncC, GascheC, and ITO staff. Management of iron-deficiency anemia in pregnancy and postpartum. In: Andrews N, BreymannC, GascheC, et al, eds. Iron therapy invarious settings. Malakoff (France): ITO; c2005[cited June 24, 2007].
WilliamsonLm, LoweS, LoveEM, et al. Serious hazards of transfusion (SHOT) initiative: Analysis pfthe first two annual reports. BMJ 1999;319: 16-9.
Seid MH, Mangione A, Valaoras TG, et al. Safety profile of iron carboxymaitose, a newhigh dose intravenous iron in patients with iron deficiency anemia. Blood 2006;108: 3739.
Van Wyck DB, Martens MG, Seid MH, Baker JB, Mangione A. Intravenous ferric car-boxymaltose compared with oral iron in the treatment of postpartum anemia: A random-ized controlled trial. Obstet Gynecol 2007:110: 267-78.
Hallberg L, Ryttinger L, Solvell L. Side-ef-fects of oral iron therapy: A doubleblind study of different iron compounds in tablet form. ActaMed Scand Suppl 1966;459: 3-10.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
