Demir Eksikliği Anemisinin Tedavisinde Ferrik Karboksimaltoz ile Demir Glisin Sülfatın Karşılaştırılması ve Bu İki Ajanın B12 Vitamini Ve Folik Asit Üzerine Etkisi: Retrospektif Bir Çalışma

Öz

Amaç: Dünya nüfusunun yaklaşık üçte birini etkilemesiyle önemli bir halk sağlığı sorunu olan anemi, en sık demir eksikliğinden kaynaklanır. Demir eksikliği anemisi, oral veya intravenöz demir replasman tedavisi gerektirir. Bu çalışmanın amacı, oral demir glisin sülfat veya intravenöz ferrik karboksimaltoz tedavileri altında başlangıçtan birinci ay takibine kadar çeşitli hematolojik parametrelerin, vitamin B12 ve folik asidin değişimini incelemektir. Yöntemler: Çalışma, 1 Ocak 2016 ve 31 Aralık 2018 tarihleri arasında oral ferröz glisin sülfat veya iv ferrik karboksimaltoz ile demir eksikliği anemisi nedeniyle tedavi edilen tüm hastaları içermiştir. Hastaların dosyalarından elde edilen yaş ve cinsiyet verilerinin yanısıra, tedavi başlangıcında ve tedaviden sonraki birinci ay kontrollerinde alınan hemoglobin, transferrin satürasyonu, ferritin, ortalama korpüsküler hacim, vitamin B12 ve folik asit değerleri kayıt edildi. Bulgular: Tedavi sonrasında elde edilen laboratuvar değerleri her iki grupta da istatistiksel olarak anlamlı iyileşme göstermiştir (grup içi, p<0,001). Gruplar arasındaki değişim yüzdesi karşılaştırıldığında: Hemoglobin, ortalama korpusküler hacim, transferrin satürasyonu ve ferritin değerlerindeki yüzde bazlı artışlar ferrik karboksimaltoz grubunda anlamlı olarak daha yüksekti (p<0,001). B12 vitamini ve folik asit değerlerindeki yüzde düşüş, oral demir glisin sülfat grubuyla karşılaştırıldığında ferrik karboksimaltoz grubunda daha yüksekti (sırasıyla p=0,005 ve p=0,001). Sonuç: Çalışmamızın bulgularına göre, demir eksikliği anemisi, ferrik karboksimaltoz kullanılarak başarılı bir şekilde tedavi edilebilir; ancak, eritropoezin uygun gelişimi için B12 vitamini ve folik asit gibi faktörlerin eş zamanlı takviyesinin gerekli olduğu unutulmamalıdır.

Anahtar Kelimeler

• Vitamin B12
• Demir
• Demir eksikliği anemisi
• Ferrik karboksimaltoz
• Folik asit
• Ferritin

Ferric Carboxymaltose Versus Ferrous Glycine Sulfate For Treatment of Iron Deficiency Anemia and Their Effect On Vitamin B12 And Folic Acid: A Retrospective Study

Abstract

Aim Anemia is a major public health problem, affecting about one-third of the world's population, and is most commonly caused by iron deficiency. Iron deficiency anemia requires oral or intravenous iron replacement therapy. The purpose of this study was to assess the change in several hematological parameters, vitamin B12, and folic acid from baseline to the first month of follow-up following therapy with oral ferrous glycine sulfate or intravenous ferric carboxymaltose. Methods: All patients who received oral ferrous glycine sulfate or intravenous ferric carboxymaltose for the treatment of iron deficiency anemia between January 1, 2016, and December 31, 2018, were included in the trial. Along with age and gender information, values of hemoglobin, ferritin, transferrin saturation, mean corpuscular volume, vitamin B12, and folic acid were derived from patients’ records at the beginning of treatment and first month follow-up. Results: Laboratory values obtained after treatment showed statistically significant improvement in both groups (intra group, p<0.001). When the percentage of change between groups was compared: Percentage-based increases in hemoglobin, mean corpuscular volume, transferrin saturation and ferritin values were significantly higher in the ferric carboxymaltose group (p<0.001). The percentage decrease in vitamin B12 and folic acid values was higher in the ferric carboxymaltose group (p=0.005 and p=0.01, respectively) when compared with oral ferrous glycine sulfate group. Conclusions: According to the findings of our study, iron deficiency anemia can be treated very successfully using ferric carboxymaltose; however, it should be remembered that concurrent supplementation of elements such vitamin B12 and folic acid is necessary for the appropriate progression of erythropoiesis.

Keywords

• Ferric carboxymaltose
• Ferritin
• Folate
• Iron
• Iron deficiency anemia
• folic acid

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