Ferric carboxymaltose reduces the number of red blood cell units transfused and allows transfusion independence to be obtained in patients with iron deficiency anemia secondary to gastrointestinal chronic blood loss

Salvadori, Ugo; Sandri, Marco; Melli, Cristina; Polese, Francesca; Simeoni, Maria; Capelli, S.; Al-Khaffaf, Ahmad

doi:10.1111/trf.13794

Cited by 12 publications

(16 citation statements)

References 25 publications

(28 reference statements)

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“…According to McDonald et al, iron replacement therapy should be considered preferable to blood transfusions to manage anaemia resulting from HHTrelated haemorrhage (3) . Several studies demonstrated that intravenous iron supplementation is safe, cost-saving and reduces transfusion requirements and the percentage of transfusion-dependent patients (34)(35)(36)(37)(38) . This is the reason why the grading scale proposed by Al-Deen and Bachmann-Harildstad in 2008, even if is commonly used and easy to understand for the patients, may be surpassed by the FID score.…”

Section: Discussionmentioning

confidence: 99%

FID Score: an effective tool in Hereditary Haemorrhagic Telangiectasia - related epistaxis

Pagella¹,

Maiorano²,

Matti³

et al. 2020

Rhin

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Background: Hereditary haemorrhagic telangiectasia (HHT) is a rare disease characterized by a multisystemic vascular dysplasia and epistaxis, that is the most common cause of disability and social impairment. Patient management strictly depends on the severity of this symptom; therefore, it is of paramount importance for the clinicians to effectively grade epistaxis severity. The aim of this report was to validate the Frequency, Intensity and Duration score (FID) for grading epistaxis severity in patients with HHT; we studied repeatability and external validity comparing FID score with Epistaxis Severity Score (ESS). Methods: This is a descriptive, observational study that included 264 adult HHT patients with epistaxis. Diagnosis of HHT was established with Curaçao criteria or positivity at genetic testing. Nosebleed severity was evaluated according to the FID score and the ESS. The first 30 patients were included in the validation of the FID score, which was graded on days 0, 1, 3 and 7. In the remaining 234 patients, a comparison between the ESS and FID score was performed. Results: The statistical analysis performed in order to validate the FID score showed very good agreement between scores calculated on different days; analysis comparing the FID score with the ESS revealed a high correlation between the two grading systems. Conclusions: The FID score is a quick, easy and precise tool for evaluating HHT-related epistaxis and could be a possible alternative to the ESS. The FID score meets the need for an intuitive and smart grading system that is easy to manage in clinicians' hands.

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Section: Discussionmentioning

confidence: 99%

FID Score: an effective tool in Hereditary Haemorrhagic Telangiectasia - related epistaxis

Pagella¹,

Maiorano²,

Matti³

et al. 2020

Rhin

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“…In these cases, administration of i.v. iron can reduce the amount of red blood cell transfusions needed, helping to overcome IDA (20). In addition, transfusion should be administered cautiously, as other comorbidities, such as ischemic heart disease, could influence the outcome (21).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Treatment With Ferric Carboxymaltose in Patients With Cirrhosis and Gastrointestinal Bleeding

Ballester-Clau

Vicente

Ramos³

et al. 2020

Front. Med.

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Background: Patients with liver cirrhosis and gastrointestinal bleeding (GIB) often develop anemia. Ferric carboxymaltose (FCM) is an intravenous (i.v.) iron formulation approved for use in patients with iron deficiency with inadequate response to oral iron therapy or when oral iron cannot be used. Here we analyzed the efficacy and safety of FCM treatment in cirrhotic patients with anemia and GIB. Methods: Retrospective observational study of patients with cirrhosis and acute or chronic GIB treated with 1,000 mg FCM at the University Hospital Arnau de Vilanova (Lleida, Spain) that follows a restrictive-transfusion strategy. All data were obtained from the patients' medical records. We used the Wilcoxon test to evaluate statistical significance. Results: Patients with cirrhosis and GIB (n = 34) were treated with 1,000 mg FCM. Portal hypertension were present in 88.2% of the patients. For hospitalized patients (n = 21), median serum hemoglobin (s-Hb) levels increased by 3.0 g/dL (p < 0.02) and 3.9 g/dL (p < 0.07) for patients treated with FCM who had or had not received also a transfusion, respectively, compared to levels recorded upon admission. For outpatients (n = 13) the mean s-Hb levels was 9.8 ± 1.6 g/dL before FCM treatment and 11.3 ± 2.1 g/dL after treatment, demonstrating a mean increase of 1.5 g/dL (p < 0.001). No serious adverse reactions to FCM were observed. Conclusion: FCM administration achieved optimal s-Hb levels in most cirrhotic patients with acute or chronic GIB, suggesting that early FCM infusion improves and maintains optimal s-Hb levels in these patients and may be an appropriate first-line therapy to treat their anemia.

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“…Other limitations to oral iron therapy are low levels of adherence, lack of suitability for patients with severe bleeding or continuous occult blood loss, the excessive time (months) required to replenish iron stores, and the lack of clarity regarding total costs, which may be higher than initially expected when absenteeism/presenteeism considerations are also taken into consideration. Newer intravenous iron compounds are considered safer than blood transfusion, have fewer GI side effects than oral iron (99,100), and are also associated with improved/guaranteed adherence (66,90,93,100,101). These compounds also provide the total iron dose required (often in a single infusion), quickly increase hemoglobin levels, and promote more effective replenishment of iron stores in comparison with oral iron (66,90,93,(100)(101)(102)(103).…”

Section: Advantages and Limitations Of Oral And Intravenous Iron Admi...mentioning

confidence: 99%

“…Newer intravenous iron compounds are considered safer than blood transfusion, have fewer GI side effects than oral iron (99,100), and are also associated with improved/guaranteed adherence (66,90,93,100,101). These compounds also provide the total iron dose required (often in a single infusion), quickly increase hemoglobin levels, and promote more effective replenishment of iron stores in comparison with oral iron (66,90,93,(100)(101)(102)(103). Much of the data supporting the efficacy and safety of intravenous iron in patients with GI bleeding come from studies of ferric carboxymaltose (FCM) (32,90,100,101).…”

Section: Advantages and Limitations Of Oral And Intravenous Iron Admi...mentioning

confidence: 99%

Indications and hemoglobin thresholds for red blood cell transfusion and iron replacement in adults with gastrointestinal bleeding: An algorithm proposed by gastroenterologists and patient blood management experts

Montoro

Cucala²,

Lanas³

et al. 2022

Front. Med.

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Ferric carboxymaltose reduces the number of red blood cell units transfused and allows transfusion independence to be obtained in patients with iron deficiency anemia secondary to gastrointestinal chronic blood loss

Abstract: In patients with IDA secondary to CBL, FCM significantly reduces the need of transfusions and achieves transfusion independence in half of the cases.

Cited by 12 publications

References 25 publications

FID Score: an effective tool in Hereditary Haemorrhagic Telangiectasia - related epistaxis

FID Score: an effective tool in Hereditary Haemorrhagic Telangiectasia - related epistaxis

Efficacy and Safety of Treatment With Ferric Carboxymaltose in Patients With Cirrhosis and Gastrointestinal Bleeding

Indications and hemoglobin thresholds for red blood cell transfusion and iron replacement in adults with gastrointestinal bleeding: An algorithm proposed by gastroenterologists and patient blood management experts

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