Intravenous Ferric Carboxymaltose for Iron Deficiency Anemia

Abstract

Research Article| February 01 2017 Intravenous Ferric Carboxymaltose for Iron Deficiency Anemia AAP Grand Rounds (2017) 37 (2): 22. https://doi.org/10.1542/gr.37-2-22 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Intravenous Ferric Carboxymaltose for Iron Deficiency Anemia. AAP Grand Rounds February 2017; 37 (2): 22. https://doi.org/10.1542/gr.37-2-22 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: ferric carboxymaltose, iron, iron deficiency anemia Source: Powers JM, Shamoun M, McCavit TL, et al. Intravenous ferric carboxymaltose in children with iron deficiency anemia who respond poorly to oral iron. J Pediatr. 2016; 180: 212– 216; doi: https://doi.org/10.1016/j.jpeds.2016.09.053Google Scholar Researchers from multiple institutions in Texas conducted a retrospective study of children with iron deficiency anemia (IDA) who received intravenous (IV) ferric carboxymaltose (FCM) at Children’s Medical Center in Dallas. A query of pharmacy records was used to identify study patients who received FCM over a 1-year period. The medical records of study patients were reviewed to assess hematologic response to FCM treatment and adverse events related to therapy. For patients weighing >50 kg, 2 doses (each up to 750 mg) were given at least 7 days apart. Children weighing <50 kg received 1 to 2 doses of FCM at 15 mg/kg/dose. Data on response to treatment were assessed 4–12 weeks after FCM administration. Patients were considered to have a complete response to treatment if their hemoglobin normalized and their serum ferritin levels were ≥15 ng/mL; partial response was defined as an increase of ≥1.0 g/dL in hemoglobin above pre-infusion level. A total of 116 IV FCM infusions were administered to 72 patients with IDA (median age, 13.7 years; range, 9 months–18 years). Data on hematologic response to treatment were assessed in 52 study patients. Among these children, the median pre-infusion and post-infusion hemoglobin values were 9.1 g/dL and 12.3 g/dL, respectively; 68% had a complete response to treatment and 30% had a partial response. Sixty-five patients (84%) experienced no adverse effects. Among the 7 patients with an adverse event, pruritis and/or urticaria were most commonly reported. One study participant developed acute dyspnea during FCM infusion that was successfully treated with diphenhydramine and hydrocortisone. The researchers conclude that FCM administered to children and adolescents with IDA is safe and highly effective. Dr. Hogan has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. IDA affects 3%–7% of children in the United States and is one of the most common nutritional disorders worldwide.1–6 Causes of IDA in toddlers include inadequate iron intake from prolonged breast-feeding or excessive cow milk ingestion.1–4 In children and adolescents, IDA is associated with restricted diets, inadequate absorption (due to proton pump inhibitors, H2 antagonists, tea, coffee, milk), heavy menstrual bleeding, chronic kidney disease, autoimmune disease, or inflammatory bowel disease.1–5 Affected toddlers may exhibit neurocognitive deficits while adolescents describe fatigue and concentration difficulties.1–5 Moderate to severe iron deficiency manifests with neurologic (restless leg syndrome, headache), cardiac, immunologic, and gastrointestinal dysfunction.5 Oral iron supplementation is available as different ferrous salts (gluconate, ascorbate, fumarate, and sulfate), all of which may be given as 3–6 mg of elemental iron/kilogram of body weight/day in divided doses over a minimum of 3 months.1–4 Ferrous sulfate is the... You do not currently have access to this content.