Factors influencing safety and efficacy of intravenous iron-carbohydrate nanomedicines: From production to clinical practice

Nikravesh, Niusha; Borchard, Gerrit; Hofmann, Heinrich; Philipp, Erik; Flühmann, Beat; Wick, Peter

doi:10.1016/j.nano.2020.102178

Cited by 37 publications

(39 citation statements)

References 80 publications

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“…It is necessary to select characterization methods more specifically, and to standardize and optimize established animal models to be easier to construct and more similar to human physiological conditions. In addition, factors that affect the safety and stability of hydrogels and osteogenic synthesis factors throughout the production, storage, transportation, treatment, and clinical application of hydrogels should be considered for better clinical application [ 138 ].…”

Section: Prospectsmentioning

confidence: 99%

Hydrogel as a Biomaterial for Bone Tissue Engineering: A Review

et al. 2020

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Severe bone damage from diseases, including extensive trauma, fractures, and bone tumors, cannot self-heal, while traditional surgical treatment may bring side effects such as infection, inflammation, and pain. As a new biomaterial with controllable mechanical properties and biocompatibility, hydrogel is widely used in bone tissue engineering (BTE) as a scaffold for growth factor transport and cell adhesion. In order to make hydrogel more suitable for the local treatment of bone diseases, hydrogel preparation methods should be combined with synthetic materials with excellent properties and advanced technologies in different fields to better control drug release in time and orientation. It is necessary to establish a complete method to evaluate the hydrogel’s properties and biocompatibility with the human body. Moreover, establishment of standard animal models of bone defects helps in studying the therapeutic effect of hydrogels on bone repair, as well as to evaluate the safety and suitability of hydrogels. Thus, this review aims to systematically summarize current studies of hydrogels in BTE, including the mechanisms for promoting bone synthesis, design, and preparation; characterization and evaluation methods; as well as to explore future applications of hydrogels in BTE.

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Section: Prospectsmentioning

confidence: 99%

Hydrogel as a Biomaterial for Bone Tissue Engineering: A Review

et al. 2020

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“…A single dose of intravenous iron may be sufficient to optimize the martial status in fragile individuals, such as older adults who are scheduled for elective orthopedic surgery, whereas oral supplements may require daily administrations for weeks [ 99 ]. Diverse intravenous iron formulas are available, with differences in unit size, nature of the carbohydrate shell (e.g., dextran, sucrose, gluconate, maltose, sorbitol), surface charge, iron form (Fe 2+ or Fe 3+ ) and content [ 106 ]. The dose of iron to be administered through parenteral routes can be calculated based on body weight and Hb levels [ 107 ], whereas the personalization of oral therapy is often missing, probably due to the perception that the vein infusion is riskier.…”

Section: The Present Of Iron Medicinementioning

confidence: 99%

“…Despite this widespread mistrust, most of the formulations are safe and supported by a positive benefit-risk ratio when using tailored dosing and monitoring [ 109 , 110 ], and appears to be more indicated than oral preparations also in conditions of gastrointestinal inflammation or when compliance to oral therapy is dubious. Nevertheless, the diversities in the costs for production, transport, storage, handling (e.g., dilution, contamination risk, in-use stability), and health care assistance render the intravenous preparations not usually considered the first choice of treatment [ 106 , 111 ].…”

Section: The Present Of Iron Medicinementioning

confidence: 99%

The Central Role of Iron in Human Nutrition: From Folk to Contemporary Medicine

et al. 2020

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Iron is a fundamental element in human history, from the dawn of civilization to contemporary days. The ancients used the metal to shape tools, to forge weapons, and even as a dietary supplement. This last indication has been handed down until today, when martial therapy is considered fundamental to correct deficiency states of anemia. The improvement of the martial status is mainly targeted with dietary supplements that often couple diverse co-factors, but other methods are available, such as parenteral preparations, dietary interventions, or real-world approaches. The oral absorption of this metal occurs in the duodenum and is highly dependent upon its oxidation state, with many absorption influencers possibly interfering with the intestinal uptake. Bone marrow and spleen represent the initial and ultimate step of iron metabolism, respectively, and the most part of body iron circulates bound to specific proteins and mainly serves to synthesize hemoglobin for new red blood cells. Whatever the martial status is, today’s knowledge about iron biochemistry allows us to embrace exceedingly personalized interventions, which however owe their success to the mythical and historical events that always accompanied this metal.

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“…They are spheroidal iron-carbohydrate nanoparticles, ranging in size from 8 to 30 nm. 3,6 Each particle consists of a central core of iron oxyhydroxide gel and a shell of carbohydrate. The carbohydrate maintains the stability of the iron and slows its release, preventing toxic reactions.…”

Section: Intravenous Iron Preparations: Similar Yet Differentmentioning

confidence: 99%

Intravenous iron: do we adequately understand the short‐ and long‐term risks in clinical practice?

Rund

2020

Br J Haematol

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Intravenous (IV) iron as a therapeutic agent is often administered but not always fully understood. The benefits of IV iron are well proven in many fields, particularly in nephrology. IV iron is beneficial not only for true iron deficiency but also for iron-restricted anaemia (functional iron deficiency). Yet, the literature on intravenous iron has many inconsistencies regarding its adverse effects. Over the last several years, newer forms of iron have been developed, leading to the more regular use of iron and in larger doses. This review will summarize some of the older and newer literature regarding the differences among iron products, including the mechanisms and frequency of their adverse events (AEs). The pathway and frequency of an underrecognized adverse event (hypophosphataemia) will be discussed. Recent insights on infection risk and iron handling by macrophages are examined. Potential but presently unproven risks of iron overload due to IV iron are discussed. The impact of these on the risk:benefit ratio and dosing of intravenous iron are considered in different clinical settings, including pregnancy and cancer. IV iron is an essential component of the therapy of anaemia and understanding these issues will enable more informed treatment decisions and knowledgeable use of these drugs.

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Factors influencing safety and efficacy of intravenous iron-carbohydrate nanomedicines: From production to clinical practice

Cited by 37 publications

References 80 publications

Hydrogel as a Biomaterial for Bone Tissue Engineering: A Review

Hydrogel as a Biomaterial for Bone Tissue Engineering: A Review

The Central Role of Iron in Human Nutrition: From Folk to Contemporary Medicine

Intravenous iron: do we adequately understand the short‐ and long‐term risks in clinical practice?

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