Treatment of iron deficiency and iron deficiency anemia with intravenous ferric carboxymaltose in pregnancy

Abdelazim, Ibrahim A.; Shikanova, Svetlana; Zhurabekova, Gulmira

doi:10.1007/s00404-018-4943-x

Cited by 10 publications

(15 citation statements)

References 7 publications

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“…22,23 In addition to Hb levels, MCV evaluation is also recommended to assess the efficacy of iron supplementation by comparing pre-and post-treatment values. 24 Reduced MCV is a marker of anemia. Similar to the increase in Hb levels, we found a significant increase in the levels of MCV in our study group.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Minimal Optimal Dose of Intravenous Ferric Carboxymaltose for Treatment of Iron Deficiency Anemia and Risk of Transient Hyperferritinemia

Alharbi¹,

Alharbi²,

Bashen³

et al. 2022

JBM

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Iron supplementation is administered orally or intravenously to treat iron-deficiency anemia (IDA). Ferric Carboxymaltose (FCM) "Ferinject ® " is an intravenous (IV) iron preparation that has emerged as a safe therapeutic option for treating IDA in the past decade. Aim: This study aimed to evaluate safety and efficacy of carboxymaltose in a cohort of patients with IDA not responding to oral therapy. Methods: This 12-month retrospective study included 106 patients with IDA, with-or without bariatric surgery, who received (single or multiple doses) of Carboxymaltose 500mg/10mL. Data points included patients' demographics, baseline data for Hb, platelet, ferritin, and MCV pre-and at 1, 2, and 3 months following different doses of IV-Carboxymaltose. Changes in Hb, MCV, platelets, and ferritin levels were recorded in response to Carboxymaltose to assess the optimal dose, risk of hyperferritinemia, and hypophosphatemia. Results: At three months (95 days) follow-up, the median change pre-and post-therapy in hemoglobin was from 9.5 to 11.9g/dL (p < 0.01), MCV 73.6-80.5fL (p < 0.01), and ferritin 5.3-93.8ng/mL. A significant difference was observed between platelet count of patients who underwent bariatric surgery and those who did not. An optimal ferritin response (>30ng/mL) was observed in 87.8% of patients who received first dose, and none of the full three doses showed no response. 37% of patients who received two doses developed hyperferritinemia. Serum phosphate levels were assessed in 28 cases, and hypophosphatemia was observed in 25% of these patients. Conclusion:Carboxymaltose is a reliable option for IDA. IV-FCM therapy helps achieve significant improvement in hemoglobin concentration and MCV from the first dose carrying a low reversible risk of hyperferritinemia following multiple doses. An interesting finding of this study is the discovery of a population of IDA patients requiring periodic assessment for iron reinfusion to sustain normal levels, mostly post-bariatric surgery. Changes in serum phosphate levels reported to occur consecutively with FCM treatment should be further studied.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Minimal Optimal Dose of Intravenous Ferric Carboxymaltose for Treatment of Iron Deficiency Anemia and Risk of Transient Hyperferritinemia

Alharbi¹,

Alharbi²,

Bashen³

et al. 2022

JBM

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“…Participants were asked during each antenatal care visit about their compliance to iron tablets, and the side effects related to oral iron as metallic taste, gastrointestinal (GIT) intolerance/upset, and/or constipation. The pre-treatment ferritin, hemoglobin, RBCs-MCV, and RBCs-MCH were compared by the post-treatment values in the two studied groups to detect the effcacy of HIO compared to FF in treatment of IDA during pregnancy as a primary outcome (16)(17)(18)(19).…”

Section: Methodsmentioning

confidence: 99%

Heme-Iron OptiFer® in the Treatment of Iron Deficiency Anemia During Pregnancy

Abdelazim

Abu-Faza

Al-Ajmi

et al. 2021

Gynecol Obstet Reprod Med

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OBJECTIVES: This study designed to compare the efficacy, and tolerability of heme-iron OptiFer® to ferrous fumarate in the treatment of iron deficiency anemia during pregnancy. STUDY DESIGN: Two hundred and thirty-four (234) women with iron deficiency anemia during pregnancy were included in this study; 121 women in the heme-iron OptiFer® group, and 113 women in the ferrous fumarate group. Women in the heme-iron OptiFer® group received OptiFer® tablets twice daily for ≥3 months then once daily as a maintenance dose. Women in the ferrous fumarate group received 350 mg oral ferrous fumarate once daily for ≥3 months. The pre-treatment ferritin, hemoglobin, red blood cells-mean corpuscular volume, and red blood cells-mean corpuscular hemoglobin were compared by the post-treatment values in the two studies. RESULTS: The post-treatment hemoglobin and ferritin were significantly high in the heme-iron OptiFer® group (11.2±7.1 gm/dL and 112.8±54.8 ug/l, respectively) compared to the ferrous fumarate group (10.9 ±5.1 and 89.9±43.3, respectively; p=0.0002 and p=0.006; respectively). The post-treatment red blood cells-mean corpuscular volume and red blood cells-mean corpuscular hemoglobin were significantly high in the heme-iron OptiFer® group (92.0±4.1 fl and 31.9±6.2 pg, respectively) compared to the ferrous fumarate group (87.7±2.9 and 28.5±4.7, respectively; p=0.0001 and p=0.001, respectively). The rates of poor compliance and gastrointestinal intolerance were significantly high in the ferrous fumarate group compared to the heme-iron OptiFer® group (12.4% and 19.5%, respectively versus 3.3% and 2.5%, respectively), (p=0.01 and p=0.0001, respectively). CONCLUSION: Heme-iron OptiFer® is an effective therapeutic option for the treatment of iron deficiency anemia during pregnancy with low side effects. heme-iron OptiFer® can be used in women who have low compliance, and/or gastrointestinal intolerance to conventional iron salts.

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“…Intravenous iron was given for correction of the patient's IDA according to the hospital protocol [7,8].…”

Section: Case Reportmentioning

confidence: 99%

Severe adenomyosis with unexpectedly high CA-125: report of a rare case

Abdelazim

Abu-Faza

Hamed

et al. 2020

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A 46-year-old woman presented to the emergency department with abdominal pain and abnormal uterine bleeding over the last year. She had a history of failed cyclic progesterone with tranexamic acid over the last 3 months to control her bleeding attacks. She had a tender pelvi-abdominal mass of 28 weeks' gestation size. Therapeutic curettage was performed, followed by correction of her iron deficiency anemia with intravenous iron. The trans-abdominal ultrasound of the pelvi-abdominal mass showed asymmetrical myometrial thickening, predominantly its anterior wall, with myometrial hyperechoic regions surrounded by hypoechoic areas suggestive of adenomyosis uterus for magnetic resonance imaging (MRI) evaluation. The MRI evaluation confirmed the diagnosis of adenomyosis uterus and showed diffuse asymmetrical uterine adenomyosis, predominantly its anterior myometrial wall, with an ill-defined endo-myometrial junction. Total abdominal hysterectomy with bilateral salpingectomy and bilateral ovarian conservation was performed after departmental approval and the patient's consent. The routine pre-operative investigations were completely normal except the cancer antigen (CA-125) which was unexpectedly high (1658 and 1046 IU/ml repeated twice two days apart). The histological examination of the surgical removed uterus confirmed the diagnosis of adenomyosis uterus and the pre-operative high CA-125 decreased to 22 IU/ml (normal range 0-35 IU/ml) one week after surgery. Conclusions: Unexpectedly high CA-125 over 1000 IU/ml can be seen in benign gynecologic conditions such as severe adenomyosis. The high CA-125 level is positively correlated to the uterine size in severe adenomyosis.

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Treatment of iron deficiency and iron deficiency anemia with intravenous ferric carboxymaltose in pregnancy

Cited by 10 publications

References 7 publications

Evaluation of Minimal Optimal Dose of Intravenous Ferric Carboxymaltose for Treatment of Iron Deficiency Anemia and Risk of Transient Hyperferritinemia

Evaluation of Minimal Optimal Dose of Intravenous Ferric Carboxymaltose for Treatment of Iron Deficiency Anemia and Risk of Transient Hyperferritinemia

Heme-Iron OptiFer® in the Treatment of Iron Deficiency Anemia During Pregnancy

Severe adenomyosis with unexpectedly high CA-125: report of a rare case

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