Implementing total-dose ferumoxytol in lieu of split-dose ferumoxytol

Abstract

BackgroundFerumoxytol is Food and Drug Administration–approved as two 510 mg infusions. Retrospective and prospective reviews have established that a single 1020 mg infusion is as efficacious and safe as two 510 mg infusions. ObjectivesTo transition our preferred intravenous iron infusion practice from two 510 mg infusions to a single 1020 mg ferumoxytol infusion. Practice descriptionThis is a prospective process improvement study conducted at Tripler Army Medical Center, a large academic medical center. Practice innovationWe set up an evidence-based project to transition and monitor our preferred iron treatment of ferumoxytol from 2 doses to 1 dose. Evaluation methodsWe collected efficacy and safety data for 188 unique patients receiving 228 infusions, of which 62 were single 1020 mg doses, and 166 were two 510 mg doses. ResultsComparing the 1020 mg dose in 62 patients with 166 patients treated with two 510 mg infusions, we found no increase in the rate of infusion reactions (4.8 % vs. 4.8 %) and comparable improvement in ferritin and hemoglobin (144 ng/mL vs. 140 ng/mL; P value = 0.874, and 1.8 g/dL vs. 1.9 g/dL; P value = 0.721, respectively). ConclusionThus, we were able to successfully transition to total-dose ferumoxytol for iron-deficient anemia, effectively reducing patient treatment visits without any difference in safety or efficacy. Ferumoxytol 1020 mg infused intravenously over 30 minutes in 250 mL normal saline single dose is a viable, safe, and effective treatment for iron-deficiency anemia.