Effectiveness and safety of an on-demand ferric carboxymaltose infusion strategy in patients with inflammatory bowel disease: a real world experience

Abstract

Background We evaluated an on-demand ferric carboxymaltose (FCM) infusion strategy in inflammatory bowel disease (IBD) patients with iron deficiency anemia (IDA). Aims The primary outcome was the response rate to single or multiple FCM infusions after 12 months. Secondary outcomes were the response rate to a single FCM infusion after 3 months and the FCM safety profile. Methods We retrospectively included 185 IBD patients who received at least one FCM infusion of 500 mg, between 2015 and 2018. FCM was administered to patients with Hb ≤10 g/dL and hypoferritinemia and repeated according to the physician’s assessment. Complete response (CR) was defined as Hb ≥12 g/dL (≥13 g/dL for men) or Hb increase ≥2 g/dL. Partial response (PR) was defined as an Hb increase between 1 and 2 g/dL. A univariate analysis was performed at 3 and 12 months. Results After 12 months, the response rate was 75.1% (CR, 48.6%; PR, 26.4%; mean number of FCM infusions, 1.7 ± 1.1). In total 169/185 patients received a single FCM infusion during the first 3 months and 79.2% achieved response (CR, 56.8%; PR, 22.4%). At univariate analysis, no variable was associated with response. No adverse events were reported. Conclusions An on-demand strategy was effective and well-tolerated in treating IDA in IBD patients.

Use of restrictive iron transfusion strategy in inflammatory bowel disease: one size does not fit all

“…Iron-deficiency anemia (IDA) is one of the commonest concomitant diseases associated with inflammatory bowel disease (IBD). Grova et al [1] evaluated the safety and efficacy of a restrictive, on-demand ferric carboxymaltose (FCM)-infusion strategy in patients with IBD and IDA in contrast to the weight and hemoglobin-based standard recommendation [2]. However, there are few issues that need to be addressed.…”

Ferric Carboxymaltose and Erythropoiesis-Stimulating Agent Treatment Reduces the Rate of Blood Transfusion in Refractory Anemia

“…Administered intravenously, it is effective in the treatment of iron deficiency anemia, delivering a replenishment dose of up to 1000 mg of iron during a minimum administration time of </= 15 min [ 13 , 14 , 15 , 16 , 17 ]. Results of several randomized trials have shown that intravenously administered FCM rapidly improves hemoglobin levels and replenishes depleted iron stores in various populations of patients with iron deficiency anemia, including those with inflammatory bowel disease [ 13 ], heavy uterine bleeding [ 14 ], postpartum iron deficiency anemia [ 15 ], heart failure [ 16 ], and chronic kidney disease [ 17 ]. It is also well tolerated in clinical trials [ 13 , 14 , 15 , 16 , 17 ].…”

“…Results of several randomized trials have shown that intravenously administered FCM rapidly improves hemoglobin levels and replenishes depleted iron stores in various populations of patients with iron deficiency anemia, including those with inflammatory bowel disease [ 13 ], heavy uterine bleeding [ 14 ], postpartum iron deficiency anemia [ 15 ], heart failure [ 16 ], and chronic kidney disease [ 17 ]. It is also well tolerated in clinical trials [ 13 , 14 , 15 , 16 , 17 ]. FCM is, therefore, an effective option in the treatment of iron deficiency anemia in patients for whom oral iron preparations are ineffective or cannot be administered.…”