Ferric Carboxymaltose in the treatment of chemotherapy-induced anaemia: an effective, safe and cost- sparing alternative to blood transfusion

Abstract

Anaemia is highly prevalent in cancer patients, adversely affects quality of life and impacts survival. The pathogenesis is multifactorial, with iron deficiency being a major and potentially treatable contributor. This study aimed to assess the effectiveness and economic impact of ferric carboxymaltose in chemotherapy-induced anaemia. This prospective cohort study between 2015–2016 of chemotherapy-treated patients for solid tumours, grade ≥2 anaemia and iron deficiency evaluated hematopoietic response four weeks after ferric carboxymaltose treatment. Transfusion rate of all cancer patients treated at our ambulatory unit during the two-year study period (2015–2016) was compared to a retrospective cohort (2013–2014) who received blood transfusion only. Between 2015–2016, 99 patients were included and treated with ferric carboxymaltose, the majority of whom (n = 81) had relative iron deficiency. Mean haemoglobin concentrations improved from 9.2 [6.7–10.8] g/dL to 10.6 [7.8–14.2] g/dL four weeks after treatment. A 26% reduction in the transfusion rate was observed from control retrospective to the prospective study group including ferric carboxymaltose treated patients [relative risk 0.74 (95% CI:0.66–0.83)]. The cost analysis showed a benefit for the use of ferric carboxymaltose in chemotherapy-induced anaemia. This study shows that ferric carboxymaltose is an effective, cost-saving support treatment, reducing the need for allogeneic transfusions saving blood units which are a limited resource.

Seven-Year Single-Center Experience of the Efficacy and Safety of Ferric Carboxymaltose in Cancer Patients with Iron-Deficiency Anemia

“…A multi-center observational study has shown that ferric carboxymaltose treatment significantly decreased transfusion rates among patients with colon cancer (9.9 vs. 38.7%; p < 0.001) [30]. Another prospective study conducted in Portugal between 2015 and 2016 showed a 26% decrease in the transfusion rate compared to the historical control group [31].…”

Oral versus intravenous iron for anemia in pregnancy: a cost-effectiveness analysis

“…4,[15][16][17][18][19] For IVFC, we assumed a dose of 750mg delivered twice over the course of one week. 6,7,[20][21][22][23] We constructed a separate model to assess the costs associated with the most common adverse reactions to each iron therapy (Supplemental).…”

Expert consensus on improving iron deficiency anemia management in obstetrics and gynecology in Asia

“…The incidence of anemia in patients with cancer varies from 20%-60% at the time of diagnosis to 60%-90% during cancer treatments. 34 The pathogenesis of IDA in cancer is multifactorial, ranging from inadequate dietary intake, inflammation, myelosuppression with chemotherapy and bone marrow infiltration by tumor cells to blood loss during surgery. 8 Anemia in these patients results in symptoms that affect quality of life, such as mental confusion, depression, nausea, and loss of appetite.…”