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intravenous iron in inflammatory bowel disease

World Journal of Gastroenterology 2009年第37期15卷 4666-4674页

作者： Manuel Muoz Susana Gómez-Ramírez José Antonio García-Erce Transfusion Medicine School of Medicine University of Málaga Málaga 29071 Spain Department of Internal Medicine University Hospital Virgen de la Victoria Málaga 29010 Spain Department of Hematology and Hemoterapy University Hospital Miguel Servet Zaragoza 50008 Spain

The prevalence of anemia across studies on patients with inflammatory bowel disease (IBD) is high (30%). Both iron defi ciency (ID) and anemia of chronic disease contribute most to the development of anemia in IBD. The prevalence of ID is even higher (45%). Anemia and ID negatively impact the patient's quality of life. Therefore, together with an adequate control of disease activity, iron replacement therapy should start as soon as anemia or ID is detected to attain a normal hemoglobin (Hb) and iron status. Many patients will respond to oral iron, but compliance may be poor, whereas intravenous (IV) compounds are safe, provide a faster Hb increase and iron store repletion, and presents a lower rate of treatment discontinuation. Absolute indications for IV iron treatment should include severe anemia, intolerance or inappropriate response to oral iron, severe intestinal disease activity, or use of an erythropoietic stimulating agent. Four different products are principally used in clinical practice, which differ in their pharmacokinetic properties and safety profi les: iron gluconate and iron sucrose (lower single doses), and iron dextran and ferric carboxymaltose (higher single doses). After the initial resolution of anemia and the repletion of iron stores, the patient's hematological and iron parameters should be carefully and periodically monitored, and maintenance iron treatment should be provided as required. New IV preparations that allow for giving 1000-1500 mg in a single session, thus facilitating patient management,provide an excellent tool to prevent or treat anemia and ID in this patient population, which in turn avoids allogeneic blood transfusion and improves their quality of life.

关键词： Inflammatory bowel disease Anemia iron deficiency Functional iron deficiency Erythropoiesisstimulating agents Oral iron intravenous iron

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intravenous iron supplementation may be superior to observation in acute isovolemic anemia after gastrectomy for cancer

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World Journal of Gastroenterology 2014年第7期20卷 1852-1857页

作者： Hong Man Yoon Young-Woo Kim Byung Ho Nam Daniel Reim Bang Wool Eom Ji Yeon Park Keun Won Ryu Gastric Cancer Branch Research Institute and HospitalNational Cancer CenterGoyangsi 410-769South Korea Cancer Registration and Biostatistics Branch and Center for Clinical Trials National Cancer CenterGoyang-si 410-769South Korea Department of Surgery Soon Chun Hyang University HospitalSeoul 140-743South Kore

AIM: To determine whether the application of post-operative intravenous (IV)-iron for acute isovolemic anemia after gastrectomy for cancer may be effective.

关键词： intravenous iron Observation Gastric cancer Acute isovolemic anemia Gastrectomy

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A randomized,controlled,open label non-inferiority trial of intravenous ferric carboxymaltose versus iron sucrose in patients with iron deficiency anemia in China

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Frontiers of Medicine 2024年第1期18卷 98-108页

作者： Jie Jin Zhihua Ran Emanuele Noseda Bernard Roubert Matthieu Marty Anna Mezzacasa Udo Michael Göring The First Affiliated Hospital Zhejiang University College of MedicineHangzhou310058China Renji Hospital Shanghai Jiao Tong University School of MedicineShanghai200025China Vifor Pharma Glattbrugg8152Switzerland

iron deficiency(ID)and ID anemia(IDA)pose significant public health concerns in *** iron sucrose(IS)treatment is well-established in the country,ferric carboxymaltose(FCM)offers the advantage of higher doses and fewer *** open label,randomized,controlled,non-inferiority trial was conducted at multiple sites in China to compare the outcomes of FCM(maximum of 2 doses,500 or 1000 mg iron)and IS(up to 11 infusions,200 mg iron)treatments in subjects with *** primary endpoint was the achievement of hemoglobin(Hb)response(an increase of⩾2 g/dL from baseline)within 8 weeks,whereas secondary endpoints included changes in Hb,transferrin saturation,and serum ferritin *** the 371 randomized subjects,a similar percentage of subjects treated with FCM and IS achieved Hb-response(FCM 99.4%,IS 98.3%),thereby confirming the non-inferiority of FCM compared with IS(difference 1.12(−2.15,4.71;95%confidence interval(CI))).Furthermore,a significantly higher proportion of FCM-treated subjects achieved early Hb-response at Week 2(FCM 85.2%,IS 73.2%;difference 12.1(3.31,20.65;95%CI)).Additionally,the increase in TSAT and serum ferritin levels from baseline was significantly greater at all time points for FCM-treated *** safety profiles of FCM and IS were comparable,with the exception of transient hypophosphatemia and pyrexia,which are consistent with FCM’s known safety *** conclusion,FCM proves to be an efficacious treatment for IDA,providing faster Hb-response and correction of ID with fewer administrations than IS.

关键词： iron deficiency anemia intravenous iron ferric carboxymaltose iron sucrose Hb response early response

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Treatment of iron deficiency anemia associated with gastrointestinal tract diseases

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World Journal of Gastroenterology 2010年第22期16卷 2720-2725页

作者： Ulas D Bayraktar Soley Bayraktar Division of Hematology and Oncology Sylvester Comprehensive Cancer Center University of Miami

The gastrointestinal (GI) tract is a common site of bleeding that may lead to iron deficiency anemia (IDA). Treatment of IDA depends on severity and acuity of patients’ signs and symptoms. While red blood cell transfusions may be required in hemodynamically unstable patients, transfusions should be avoided in chronically anemic patients due to their potential side effects and cost. iron studies need to be performed after episodes of GI bleeding and stores need to be replenished before anemia develops. Oral iron preparations are efficacious but poorly tolerated due to non-absorbed iron-mediated GI side effects. However, oral iron dose may be reduced with no effect on its efficacy while decreasing side effects and patient discontinuation rates. Parenteral iron therapy replenishes iron stores quicker and is better tolerated than oral therapy. Serious hypersensitive reactions are very rare with new intravenous preparations. While data on worsening of inflammatory bowel disease (IBD) activity by oral iron therapy are not conclusive, parenteral iron therapy still seems to be advantageous in the treatment of IDA in patients with IBD, because oral iron may not be sufficient to overcome the chronic blood loss and GI side effects of oral iron which may mimic IBD exacerbation. Finally, we believe the choice of oral vs parenteral iron therapy in patients with IBD should primarily depend on acuity and severity of patients’ signs and symptoms.

关键词： Anemia Inflammatory bowel disease intravenous iron iron deficiency Oral iron

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Perioperative anemia management in colorectal cancer patients:A pragmatic approach

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World Journal of Gastroenterology 2014年第8期20卷 1972-1985页

作者： Manuel Muoz Susana Gómez-Ramírez Elisa Martín-Montaez Michael Auerbach Transfusion Medicine School of MedicineUniversity of Málaga29071-MálagaSpain Internal Medicine University Hospital Virgen de la Victoria29071-MálagaSpain Department of Pharmacology School of MedicineUniversity of Málaga29071-MálagaSpain Georgetown University School of Medicine WashingtonDC 20057United States

Anemia,usually due to iron deficiency,is highly prevalent among patients with colorectal *** cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron *** anemia predicts for decreased *** blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes,increased post-operative nosocomial infections,longer hospital stays,increased rates of cancer recurrence and perioperative venous *** are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management,minimizes or eliminates allogeneic blood *** includes restrictive transfusion policy,thromboprophylaxis and anemia management to improve *** of preoperative hemoglobin levels is a World Health Organization *** repletion should be routinely ordered when *** iron is poorly tolerated with low adherence based on published *** iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion *** adverse events with intravenous iron are extremely *** formulations allow complete replacement dosing in 15-60 min markedly facilitating *** stimulating agents may improve response rates.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes.

关键词： Colorectal cancer Anemia Allogeneic blood transfusion intravenous iron Erythropoiesis stimulating agents Patient Blood Management

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Parenteral iron therapy in children with iron deficiency anemia

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World Journal of Clinical Cases 2024年第13期12卷 2138-2142页

作者： Jelena Roganovic Department of Pediatric Hematology and Oncology Children’s Hospital Zagreb10000 ZagrebCroatia Faculty of Biotechnology and Drug Development University of RijekaRijeka 51000Croatia

iron deficiency anemia(IDA)continues to be a global public health *** iron is the universally accepted first-line therapy,and most children have a prompt and favorable response to oral *** subsets of children who fail to respond due to intolerance,poor adherence,or inadequate intestinal absorption,parenteral iron is *** numerous studies in adults with IDA of diverse etiologies,pediatric studies on parenteral iron use are very *** mostly retrospective and small,these studies have documented the efficacy and safety profile of intravenous iron *** this editorial the author comments on the most important published data and underscores the need to seriously consider parenteral iron use in children unresponsive to oral therapy.

关键词： Anemia iron deficiency intravenous iron iron deficiency anemia Children

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