Intravenous Ferric Carboxymaltose in Children with Iron Deficiency Anemia Who Respond Poorly to Oral Iron

Powers, Jacquelyn; Shamoun, Mark; McCavit, Timothy L.; Adix, Leah; Buchanan, George R.

doi:10.1016/j.jpeds.2016.09.053

Cited by 67 publications

(70 citation statements)

References 21 publications

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“…Indeed, the available pediatric experience with third generation intravenous iron products is very limited. Recently, investigators at Children's Medical Center of Dallas showed that ferric carboxymaltose administered as a short intravenous infusion without a test dose was safe and highly effective in a diverse population of infants, children, and adolescents with IDA refractory to oral iron therapy . We have reported similar preliminary pediatric experience with ferric carboxymaltose in Greece and Croatia …”

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confidence: 63%

Intravenous iron: Safe and underutilized in children

Mantadakis

2018

Pediatric Blood & Cancer

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confidence: 63%

Intravenous iron: Safe and underutilized in children

Mantadakis

2018

Pediatric Blood & Cancer

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“…This is an off-label use of this medication (<14 years of age). Other investigators have more recently demonstrated safety of FCM in even younger age groups, not specific to IBD [30]. We have selected lower risk cases by excluding those with a personal history of severe allergy, atopy or anaphylaxis to other agents.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of parenteral iron in children with inflammatory bowel disease

Papadopoulos

Patel

Korologou-Linden³

et al. 2018

Brit J Clinical Pharma

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Objectives: Iron deficiency anemia (IDA) frequently complicates inflammatory bowel disease (IBD) in children and adults. Oral iron may exacerbate gastrointestinal symptoms and absorption may be insufficient in intestinal inflammation. Even where oral iron is successful, repletion of iron stores can be unacceptably slow. Intravenous (IV) iron compounds were in the past associated with serious adverse reactions and historically were considered a last resort in children. New generation preparations have a safer profile in adults although reluctance to use them in children may persist, where safety data is lacking. We investigate the safety and efficacy of ferric carboxymaltose (FCM) and iron sucrose (IS) in children. Methods:We retrospectively identified all children with IBD who received parenteral iron over a 38 month period in a single regional referral centre. Safety, tolerability and adverse events were established by case note review. Efficacy was assessed by change in hematinic indices pre-and posttreatment.Results: 47 children (18 male; median age 14yrs, range 3-17) received a total of 104 iron infusions. 44% (21) had Crohn's disease (CD); 56% (27) ulcerative colitis (UC). 40 received FC, eight IS and one both. Three children developed mild rash post infusion which resolved quickly with chlorphenamine. Mean increase in hemoglobin (Hb) was 2.5g/dl (0.3-5.8). Iron levels increased by a mean of 8.4 g/dl (1-25), transfer in saturation by 16.2% (2-47). Transfer in decreased by 0.84 g/dl (0.3-3.4). Conclusion:New generation parenteral iron preparations are safe, well tolerated and efficacious in children with IDA and IBD.What is known: Iron deficiency anemia (IDA) is a common complication of inflammatory bowel disease (IBD) and a significant contributor to morbidity.IDA should be actively treated in IBD.Parenteral iron is effective and relatively safe in adults. What is new:The intravenous iron preparations ferric carboxymaltose (FCM) and iron sucrose (IS) are effective treatments for IDA in children with IBD. The safety profiles of FCM and IS are favourable, and similar in children to that in adults.

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“…Unfortunately, the associated stigma persists and is often linked to all IV iron formulations, including the much safer and highly effective newer formulations . The three primary formulations that have been used historically in pediatrics are iron sucrose (IS), low molecular weight iron dextran (LMWID), and sodium ferric gluconate complex (FG), though newer formulations such as ferric carboxymaltose and ferumoxytol are now being studied as well . A few studies in small pediatric cohorts, mostly in hematology patients with IDA, have demonstrated that IV iron is both safe and effective .…”

Section: Introductionmentioning

confidence: 99%