Efficacy and safety of ferric carboxymaltose for the management of iron deficiency anemia in women
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252034Keywords:
Iron deficiency Anemia, Women, Ferric carboxy maltoseAbstract
Iron deficiency anemia (IDA) remains the most common nutritional deficiency across the world with about1in four people suffering from anemia. Iron deficiency anemia spans across the life of a female. Healthy females absorb 5.6% of iron in diet. The efficacy of oral iron is diminished when uptake through the gut is impaired or when iron losses are large and/or continuous (eg, menorrhagia, gastrointestinal bleeding, or post-surgery). Dose-dependent gastrointestinal side effects hinder compliance and result in poor patient compliance in upto 50% of patients. For patients who are diagnosed with IDA during 2nd or 3rd trimesters, intravenous iron replacement therapy (IRT) is recommended. One of the commonly used parenteral iron formulations include ferric carboxymaltose (FCM). Iron supplied as FCM is quickly distributed to different tissues. In randomized trials in pregnant women with IDA, postpartum women with anemia and women with heavy menstrual bleeding, treatment with FCM significantly improved hemoglobin levels compared with oral iron treatment. Ferric carboxymaltose can be used at high doses and allows rapid administration (up to1000 mg in a single dose infused in 15 min). Since FCM is a dextran-free, it does not react with dextran antibodies, thus resulting in a lower risk for hypersensitivity reaction. The novel iron formulation ferric carboxymaltose (FCM) has a better potential for restoring the iron stores. It reduces the dosage frequency which is the chief drawback of parenteral preparations and there is minimal drug related adverse effects. Hence FCM can be the drug of choice for the management of iron deficiency anemia in women.
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References
Bellad MB, Patted A, Derman RJ. Is It Time to Alter the Standard of Care for Iron Deficiency/Iron Deficiency Anemia in Reproductive-Age Women? Biomedicines. 2024;12(2):278.
Obaid M, Abdelazim IA, AbuFaza M, Al-Khatlan HS, Al-Tuhoo AM, Alkhaldi FH. Efficacy of ferric carboxy maltose in treatment of iron deficiency/iron deficiency anaemia during pregnancy. Prz Menopauzalny. 2023;22(1):16-20. DOI: https://doi.org/10.5114/pm.2023.126347
Jimenez K, Kulnigg-Dabsch S, Gasche C. Management of Iron Deficiency Anemia. Gastroenterol Hepatol (N Y). 2015;11(4):241-50.
Chawla S, Singh A, Jhamb D, Anupama CH. A Randomised Controlled Trial to Compare Injection Ferric Carboxymaltose and Oral Iron in Treating Iron Deficiency Anemia During Pregnancy. J ObstetGynaecol India. 2022;72(6):492-9. DOI: https://doi.org/10.1007/s13224-022-01653-8
Friedman AJ, Chen Z, Ford P, Johnson CA, Lopez AM, Shander A, et al. Iron deficiency anemia in women across the life span. J Womens Health (Larchmt). 2012;21(12):1282-9. DOI: https://doi.org/10.1089/jwh.2012.3713
Ivan EA, Mangaiarkkarasi A. Evaluation of anaemia in booked antenatal mothers during the last trimester. J Clin Diagn Res. 2013;7(11):2487-90. DOI: https://doi.org/10.7860/JCDR/2013/6370.3586
Bodnar LM, Scanlon KS, Freedman DS, Siega-Riz AM, Cogswell ME. High prevalence of postpartum anemia among low-income women in the United States. Am J Obstet Gynecol. 2001;185(2):438-43. DOI: https://doi.org/10.1067/mob.2001.115996
Iolascon A, Andolfo I, Russo R, Sanchez M, Busti F, Swinkels D, et al; EHA‐SWG Red Cell and Iron. Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia. Hemasphere. 2024;8(7):e108. DOI: https://doi.org/10.1002/hem3.108
Patted B, Patted A, Derman RJ. Is It Time to Alter the Standard of Care for Iron Deficiency/Iron Deficiency Anemia in Reproductive-Age Women? Biomedicines. 2024;12(2):278. DOI: https://doi.org/10.3390/biomedicines12020278
Markova V, Norgaard A, Jorgensen KJ, Langhoff-Roos J. Treatment for women with postpartum iron deficiency anaemia. Cochrane Database Syst Rev. 2015;8:CD010861. DOI: https://doi.org/10.1002/14651858.CD010861.pub2
Auerbach M, Adamson JW. How we diagnose and treat iron deficiency anemia. Am J Hematol. 2016;91(1):31-8. DOI: https://doi.org/10.1002/ajh.24201
Lyseng-Williamson KA, Keating GM. Ferric Carboxymaltose. Drugs. 2009;69:739-56. DOI: https://doi.org/10.2165/00003495-200969060-00007
Toblli JE, Angerosa M. Optimizing iron delivery in the management of anemia: patient considerations and the role of ferric carboxymaltose. Drug Design, Development and Therapy. 2014;8:2475-91. DOI: https://doi.org/10.2147/DDDT.S55499
Van Wyck DB, Martens MG, Seid MH, Baker JB, Mangione A. Intravenous ferric carboxymaltose compared with oral iron in the treatment of postpartum anemia: a randomized controlled trial. Obstet Gynecol. 2007;110(2):267-78. DOI: https://doi.org/10.1097/01.AOG.0000275286.03283.18
Seid MH, Derman RJ, Baker JB, Banach W, Goldberg C, Rogers R. Ferric carboxymaltose injection in the treatment of postpartum iron deficiency anemia: a randomized controlled clinical trial. Am J Obstet Gynecol. 2008;199(4):435. DOI: https://doi.org/10.1016/j.ajog.2008.07.046
Li M, Wright A, Rahim AM, Tan KH, Tagore S. Retrospective Study Comparing Treatment Outcomes in Obstetric Patients with Iron Deficiency Anemia Treated With and Without Intravenous Ferric Carboxymaltose. Cureus. 2024;16(3):e55713. DOI: https://doi.org/10.7759/cureus.55713
Froessler B, Collingwood J, Hodyl NA, Dekker G. Intravenous ferric carboxymaltose for anaemia in pregnancy. BMC Pregnancy Childbirth. 2014;14:115. DOI: https://doi.org/10.1186/1471-2393-14-115
Jose A, Mahey R, Sharma JB, Bhatla N, Saxena R, Kalaivani M, Kriplani A. Comparison of ferric Carboxymaltose and iron sucrose complex for treatment of iron deficiency anemia in pregnancy- randomised controlled trial. BMC Pregnancy Childbirth. 2019;19(1):54. DOI: https://doi.org/10.1186/s12884-019-2200-3
Breymann C, Milman N, Mezzacasa A, Bernard R, Dudenhausen J; FER-ASAP investigators. Ferric carboxymaltose vs. oral iron in the treatment of pregnant women with iron deficiency anemia: an international, open-label, randomized controlled trial (FER-ASAP). J Perinat Med. 2017;45(4):443-53. DOI: https://doi.org/10.1515/jpm-2016-0050
Pels A, Ganzevoort W. Safety and Efficacy of Ferric Carboxymaltose in Anemic Pregnant Women: A Retrospective Case Control Study. Obstet Gynecol Int. 2015;2015:728952. DOI: https://doi.org/10.1155/2015/728952
Maitri V, Tushar D, Dhiren M, Shrey D, Gayatri D. A Hospital Based Study to Access the Usefulness of Using the Combination Regime of the Ferric Carboxy Maltose, Vitamin B12 and Folic Acid as a Treatment of Severe Anemia among Pregnant Women in a Rural Tribal Community of South Gujarat. Indian J Community Med. 2022;47(3):437-40. DOI: https://doi.org/10.4103/ijcm.ijcm_964_21
Rathod S, Samal SK, Mahapatra PC, Samal S. Ferric carboxymaltose: A revolution in the treatment of postpartum anemia in Indian women. Int J App Basic Med Res 2015;5:25-30. DOI: https://doi.org/10.4103/2229-516X.149230
Mishra V, Roy P, Gandhi K, Choudhary S, Aggarwal R, Sokabaj S. Safety and Efficacy of Intravenous Ferric Carboxy Maltose in Iron Deficiency Anaemia During Post-partum Period. J Nepal Health Res Counc. 2018;15(3):208-11. DOI: https://doi.org/10.3126/jnhrc.v15i3.18841
Damineni SC, Thunga S. IV Ferric Carboxymaltose Vs Oral Iron in the Treatment of Post- partum Iron Deficiency Anaemia. J Clin Diagn Res. 2016;10(11):QC08-10. DOI: https://doi.org/10.7860/JCDR/2016/19375.8937
Hagras AM, Hussein NA, Abdelazim I, Elhamamy N. Ferric carboxymaltose for treatment of iron deficiency and iron deficiency anemia caused by abnormal uterine bleeding. PrzMenopauzalny. 2022 Dec;21(4):223-228. DOI: https://doi.org/10.5114/pm.2022.124013
Christoph P, Schuller C, Studer H, Irion O, De Tejada BM, Surbek D. Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose. J Perinat Med. 2012;40(5):469-74. DOI: https://doi.org/10.1515/jpm-2011-0231
Pfenniger A, Schuller C, Christoph P, Surbek D. Safety and efficacy of high-dose intravenous iron carboxymaltose vs. iron sucrose for treatment of postpartum anemia. J Perinat Med. 2012;40(4):397-402. DOI: https://doi.org/10.1515/jpm-2011-0239
Lee S, Ryu KJ, Lee ES, Lee KH, Lee JJ, Kim T. Comparative efficacy and safety of intravenous ferric carboxymaltose and iron sucrose for the treatment of preoperative anemia in patients with menorrhagia: An open‐label, multicenter, randomized study. J Obstet Gynaecol Res. 2019;45(4):858-64. DOI: https://doi.org/10.1111/jog.13893
Świątczak M, Młodziński K, Sikorska K, Raczak A, Lipiński P, Daniłowicz-Szymanowicz L. Chronic fatigue syndrome in patients with deteriorated iron metabolism. Diagnostics. 2022;12(9):2057. DOI: https://doi.org/10.3390/diagnostics12092057
Joshi SD, Chikkagowdra S, Kumar V. Comparative study of efficacy and safety of intravenous ferric carboxy maltose versus iron sucrose in treatment of postpartum iron deficiency anemia. Int J Reprod Contracept Obstet Gynecol. 2016;5(8):2566-70. DOI: https://doi.org/10.18203/2320-1770.ijrcog20162199
Sanavelli RJ, Gillella V. A study on safety and efficacy of FCM in comparison with iron sucrose in iron deficiency anaemia in antenatal women in a rural tertiary care hospital. Int J Acad Med Pharm. 2023;5(3):828-32.
Dillon R, Momoh I, Francis Y, Cameron L, Harrison CN, Radia D. Comparative efficacy of three forms of parenteral iron. J Blood Transfusion. 2012;2012(1):473514. DOI: https://doi.org/10.1155/2012/473514
Hussain I, Bhoyroo J, Butcher A, Koch TA, He A, Bregman DB. Direct comparison of the safety and efficacy of ferric carboxymaltose versus iron dextran in patients with iron deficiency anemia. Anemia. 2013;2013(1):169107. DOI: https://doi.org/10.1155/2013/169107
Fishbane S, Ungureanu VD, Maesaka JK, Kaupke CJ, Lim V, Wish J. The safety of intravenous iron dextran in hemodialysis patients. Am J Kidney Dis. 1996;28(4):529-34. DOI: https://doi.org/10.1016/S0272-6386(96)90463-1
Maladkar M, Yadav A, Ranade T. From Tradition to Innovation: The Clinical Edge of Ferric Carboxymaltose in Managing Iron Deficiency Anemia. Indian Practitioner. 2024;77(8).