Evaluation of ferric carboxymaltose treatment efficacy in women with postpartum iron deficiency anemia

Year 2021, Volume: 4 Issue: 1, 23 - 27, 21.01.2021

Mustafa Tekin , Navdar Doğuş Uzun , Fulya Uzun

https://doi.org/10.32322/jhsm.800829

Abstract

Aim: Anemia due to iron deficiency is a commonly seen problem among Turkish women. Especially among the pregnant women and particularyly postpartum period its rate increases. In this study, we aimed to evaluate the efficacy of intravenous ferric carbomaltose administration in anemic women in postpartum period.

Materials and Methods: The hemoglobin (Hb) and hematocrit (Htc) values of 64 patients who received intravenous ferric carboxymaltose treatment between January 1, 2020 and July 1, 2020 in Mardin State Hospital, Gynecology and Obstetrics Clinic were retrospectively evaluated. Patients who received intravenous iron carbomaltose treatment for postpartum iron deficiency anemia were compared after treatment. The length of stay in the hospital and whether the patient priorly received an erythrocyte suspension were evaluated.8

Results: The population that was given intravenous (iv) ferric carbomaltose mostly due to anemia post-cesarean and normal delivery (NSD) was included in the study Pregnancy week and hospitalization duration means were significantly higher in the C/S group (p<0.05). A statistically significant increase was observed in Hb and Htc values after intravenous iron treatment given after cesarean delivery. (p<0.05). The birth rate was higher in the young and normal group, and it was statistically significant (p<0.01). A significant increase in control hemoglobin values was observed after 10 days in patients who received intravenous iron therapy.

Conclusion: In postpartum period, iv ferric carbomaltose use for moderate anemia is a safe and logical approach.

Keywords

Anemia, Ferric Carboxymaltose, Hemoglobin, Iron Deficiency Anemia, Intravenous Iron

Doğum sonrası demir eksikliği anemisi olan kadınlarda ferrik karboksimaltoz tedavisinin etkinliğinin değerlendirilmesi

Abstract

Amaç: Demir eksikliğine bağlı anemi, Türk kadınları arasında sık görülen bir sorundur. Özellikle gebelerde ve özellikle doğum sonrası dönemde anemi oranları artmaktadır. Bu çalışmada postpartum dönemde anemili kadınlarda intravenöz ferrik karbomaltoz uygulamasının etkinliğini değerlendirmeyi amaçladık.

Gereç ve Yöntem: 1 Ocak 2020 ile 1 Temmuz 2020 tarihleri arasında Mardin Devlet Hastanesi Kadın Hastalıkları ve Doğum Kliniği'nde intravenöz ferrik karboksimaltoz tedavisi alan 64 doğum sonrası hastanın hemoglobin ve hematokrit değerleri retrospektif olarak değerlendirildi. Postpartum demir eksikliği anemisi için intravenöz demir karbomaltoz tedavisi alan hastalar tedavi sonrası karşılaştırıldı. Hastanede kalış süresi ve hastanın daha önce eritrosit süspansiyonu alıp almadığı değerlendirildi.

Bulgular: Çoğunlukla sezaryen sonrası anemi ve normal doğum (NSD) nedeniyle intravenöz ferrik karbomaltoz verilen popülasyon çalışmaya dahil edildi. Gebelik haftası ve hastanede kalış süresi ortalamaları C / S grubunda anlamlı olarak daha yüksekti (p <0.05). Sezaryen doğum sonrası verilen intravenöz demir tedavisi sonrası Hb ve Htc değerlerinde istatistiksel olarak anlamlı artış gözlendi. (p <0.05). Genç ve normal doğum yapan grupta son Hb değeri daha yüksekti ve istatistiksel olarak anlamlıydı (p <0.01). İntravenöz demir tedavisi alan hastalarda 10 gün sonra kontrol hemoglobin değerlerinde önemli bir artış gözlenmiştir.

Sonuç: Postpartum dönemde, orta derecede anemi için iv ferrik karbomaltoz kullanımı güvenli ve mantıklı bir yaklaşımdır.

Keywords

Anemi, Ferrik Karboksimaltoz, Hemoglobin, Demir Eksikliği Anemisi, İntravenöz Demir

References

• Moore RA, Gaskell H, Rose P, Allan J. Meta-analysis of efficacy and safety of intravenous ferric carboxymaltose (Ferinject) from clinical trial reports and published trial data. BMC Blood Disord 2011; 11: 4.
• World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity.Geneva,Switzerland, 2011.
• Prakash S, Yadav K. Maternal Anemia in Pregnancy: An Overview. IJPPR 2015; 4: 164-79.
• Johnson-Wimbley TD, Graham DY. Diagnosis and management of iron deficiency anemia in the 21st century. Therap Adv Gastroenterol 2011; 4: 177-184.
• Laura Percy, Diana Mansour, Ian Fraser. Iron deficiency and iron deficiency anaemia in women. Best Pract Res Clin Obstet Gynaecol 2017; 40: 55-67.
• Low MS, Grigoriadis G. Iron deficiency and new insights into therapy. Med J Aust 2017; 207: 81-7.
• C Breymann, C Honegger, I Hösli, D Surbek. Diagnosis and treatment of iron-deficiency anaemia in pregnancy and postpartum. Arch Gynecol Obstet 2017; 296: 1229-34.
• Pollock RF, Muduma G. A patient-level cost-effectiveness analysis of iron isomaltoside versus ferric carboxymaltose for the treatment of iron deficiency anemia in the United Kingdom. J Med Econ 2020; 23: 751-9.
• Avni T, Bieber A, Steinmetz T, Leibovici L, Gafter-Gvili A. Treatment of anemia in inflammatory bowel disease--systematic review and meta-analysis. PLoS One 2013; 8: e75540.
• Bonovas S, Fiorino G, Allocca M, et al. Intravenous Versus Oral Iron for the Treatment of Anemia in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore) 2016; 95: e2308.
• Avni T, Leibovici L, Gafter-Gvili A. Iron supplementation for the treatment of chronic heart failure and iron deficiency: systematic review and meta-analysis. Eur J Heart Fail 2012; 14: 423–9.
• O'Lone EL, Hodson EM, Nistor I, Bolignano D, Webster AC, Craig JC. Parenteral versus oral iron therapy for adults and children with chronic kidney disease. Cochrane Database Syst Rev 2019; 2: CD007857.
• Susantitaphong P, Alqahtani F, Jaber BL. Efficacy and safety of intravenous iron therapy for functional iron deficiency anemia in hemodialysis patients: a meta-analysis. Am J Nephrol 2014; 39: 130–41.
• Reveiz L, Gyte GM, Cuervo LG, Casasbuenas A. Treatments for iron-deficiency anaemia in pregnancy. Cochrane Database Syst Rev 2011; 10: CD003094.
• Lindgren S, Wikman O, Befrits R, et al. Intravenous iron sucrose is superior to oral iron sulphate for correcting anaemia and restoring iron stores in IBD patients: A randomized, controlled, evaluator-blind, multicentre study. Scand J Gastroenterol 2009; 44: 838–45.
• Linda M Mundy, Stefan Wohlfeil. A comment on the comparative safety of intravenous ferumoxytol versus ferric carboxymaltose in iron deficiency anemia. Am J Hematol 2018; 93: E231-E232.
• Hreinsson JP, Jonasson JG, Bjornsson ES. Bleeding-related symptoms in colorectal cancer: a 4-year nationwide population-based study. Aliment Pharmacol Ther 2013; 39: 77–84.
• Auerbach M, Macdougall IC. Safety of intravenous iron formulations: facts and folklore. Blood transfus 2014; 12: 296–300.
• Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med 2008; 36: 2667–74.
• Shander A, Hofmann A, Ozawa S, Theusinger OM, Gombotz H, Spahn DR. Activity-based costs of blood transfusions in surgical patients at four hospitals. Transfusion 2010; 50: 753–65.
• Glenngard AH, Persson U, Soderman C. Costs associated with blood transfusions in Sweden-the societal cost of autologous, allogeneic and perioperative RBC transfusion. Transfus Med 2005; 15: 295–306.
• Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int Suppl 2012; 2: 280–335.
• Breymann C, Honegger C, Holzgreve W, Surbek D. Diagnosis and treatment of iron-deficiency anaemia during pregnancy and postpartum. Arch Gynecol Obstet 2010; 282: 577-580.
• Macdougall IC, Vernon K. Complement activation-related pseudoallergy: a fresh look at hypersensitivity reactions to intravenous iron. Am J Nephrol 2017; 45: 60–2.
• Kant S, Kaur R, Ahamed F, Singh A, Malhotra S, Kumar R. Effectiveness of intravenous ferric carboxymaltose in improving hemoglobin level among postpartum women with moderate-to-severe anemia at a secondary care hospital in Faridabad, Haryana - An interventional study. Indian J Public Health 2020; 64: 168-72.