Drug utilization study and safety profile of iron isomaltoside 1000 in treatment of iron deficiency anemia in cancer patients:  a retrospective study

Davinder Paul; Manish Mahajan; Suyash Bharat; Richa Tripathi

doi:10.18203/2320-6012.ijrms20251433

Authors

Davinder Paul Department of Medical Oncology, Fortis Hospital, Ludhiana, Punjab, India
Manish Mahajan Department of Medical Affairs, Zydus Biologics, Zydus Lifesciences Ltd, Ahmedabad, Gujarat, India
Suyash Bharat Department of Medical Affairs, Zydus Biologics, Zydus Lifesciences Ltd, Ahmedabad, Gujarat, India
Richa Tripathi Department of Medical Affairs, Zydus Biologics, Zydus Lifesciences Ltd, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251433

Keywords:

Anemia, Oncology patients, Red blood cell transfusions, Iron therapy, Feruno, Iron Isomaltoside 1000, Iron deficiency anemia

Abstract

Background: Anemia is prevalent among cancer patients, affecting 39.3% to 63.4%, depending on the diagnostic threshold used. Cancer treatments often exacerbate anemia, significantly impacting patients' quality of life. In 2019, Feruno (Iron Isomaltoside 1000) was introduced in India for rapid intravenous infusion, offering controlled and gradual iron release, thereby reducing toxicity risks. Studies have confirmed its safety, effectiveness, and tolerability across various patient populations.

Methods: This single-centre, retrospective drug utilization study evaluated Iron Isomaltoside 1000 (Feruno) in 98 cancer patients with iron deficiency anemia.

Results: The mean age of patients was 56 years, with breast, ovarian, and colon cancers being the most common. The average iron requirement was 1,396.9 mg, and the most frequently administered dosage was 1,000 mg. The treatment was effective and well-tolerated, with minimal adverse reactions.

Conclusions: Iron Isomaltoside demonstrated a good safety profile. The iron requirement in cancer patients is usually above 1 gram, and the most frequently prescribed dose was 1,000 mg. To improve patient compliance and leverage the benefit of a higher dose (20 mg/kg body weight) administered in a single infusion, most patients can be treated effectively with a total dose infusion.

Metrics

Metrics Loading ...

References

Birgegård G, Henry D, Glaspy J, Chopra R, Thomsen LL, Auerbach M. A Randomized Noninferiority Trial of Intravenous Iron Isomaltoside versus Oral Iron Sulfate in Patients with Nonmyeloid Malignancies and Anemia Receiving Chemotherapy: The PROFOUND Trial. Pharmacotherapy. 2016;36(4):402-14. DOI: https://doi.org/10.1002/phar.1729

McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr. 2009;12(4):444-54. DOI: https://doi.org/10.1017/S1368980008002401

Gilreath JA, Rodgers GM. How I treat cancer-associated anemia. Blood. 2020;136(7):801-13. DOI: https://doi.org/10.1182/blood.2019004017

Cella D, Kallich J, McDermott A, Xu X. The longitudinal relationship of hemoglobin, fatigue and quality of life in anemic cancer patients: results from five randomized clinical trials. Ann Oncol. 2004;15(6):979-86. DOI: https://doi.org/10.1093/annonc/mdh235

Koch TA, Myers J, Goodnough LT. Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations. Anemia. 2015;2015:763576.

Knight K, Wade S, Balducci L. Prevalence and outcomes of anemia in cancer: a systematic review of the literature. Am J Med. 2004;116(7A):11S-26S. DOI: https://doi.org/10.1016/j.amjmed.2003.12.008

Kifle E, Hussein M, Alemu J, Tigeneh W. Prevalence of Anemia and Associated Factors among Newly Diagnosed Patients with Solid Malignancy at Tikur Anbessa Specialized Hospital, Radiotherapy Center, Addis Ababa, Ethiopia. Adv Hematol. 2019;2019:8279789. DOI: https://doi.org/10.1155/2019/8279789

Xu H, Xu L, Page JH, Cannavale K, Sattayapiwat O, Rodriguez R, et al. Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010-2013. Clin Epidemiol. 2016;8:61-71. DOI: https://doi.org/10.2147/CLEP.S89480

Majumdar S, Shet AS. Cancer-related anemia in Northeast India: Many questions and few answers. Cancer Res Statistics Treatment. 2021;4(1):163-4. DOI: https://doi.org/10.4103/crst.crst_13_21

Sundriyal D, Nayak PP, Arya L, Walia M, Saha R. Evaluation of Iron Status in Patients of Solid Organ Malignancies: Study from a Cancer Research Centre. Indian J Surg Oncol. 2020;11(1):56-9. DOI: https://doi.org/10.1007/s13193-019-00986-7

Parikh PM, Aggarwal S, Biswas G, Gulia S, Agarwala V, Basade M, et al. Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries. South Asian J Cancer. 2023;12(2):93-9. DOI: https://doi.org/10.1055/s-0043-1771445

Bohlius J, Weingart O, Trelle S, Engert A. Cancer-related anemia and recombinant human erythropoietin--an updated overview. Nat Clin Pract Oncol. 2006;3(3):152-64. DOI: https://doi.org/10.1038/ncponc0451

Madeddu C, Gramignano G, Astara G, Demontis R, Sanna E, Atzeni V, et al. Pathogenesis and Treatment Options of Cancer Related Anemia: Perspective for a Targeted Mechanism-Based Approach. Front Physiol. 2018;9:1294. DOI: https://doi.org/10.3389/fphys.2018.01294

Koch TA, Myers J, Goodnough LT. Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations. Anemia. 2015;2015:763576. DOI: https://doi.org/10.1155/2015/763576

Pollock RF, Muduma G. An Economic Evaluation of Iron Isomaltoside 1000 Versus Ferric Carboxymaltose in Patients with Inflammatory Bowel Disease and Iron Deficiency Anemia in Denmark. Adv Ther. 2018;35(12):2128-37. DOI: https://doi.org/10.1007/s12325-018-0827-5

Dicato M, Plawny L, Diederich M. Anemia in cancer. Ann Oncol. 2010;21(7):167-72. DOI: https://doi.org/10.1093/annonc/mdq284