Demir eksikliği olan kadınlarda demir karboksimaltoz tedavisinin hayat kalitesine etkisi

Abstract

Amaç: Demir eksikliği anemisi; en sık tespit edilen anemi nedeni olup, gelişmiş ülkelerde bile kadınların %20’sini etkilemektedir. Bu çalışmada parenteral ferrik karboksimaltoz tedavisinin hastaların yaşam kalitesine olan etkisi değerlendirilmiştir.
Yöntemler: Bu retrospektif kohort çalışma SBÜ Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde yapılmıştır. Parenteral ferrik karboksimaltoz tedavisi verilen 50 hastada, tedavi öncesi ve sonrası 6. hafta arasında yaşam kalitesi açısından değişim; Kısa Form 36 ölçeği kullanılarak değerlendirilmiştir.
Bulgular: Tedavi öncesi hemoglobin düzeyi 8,22 gr/dl iken tedavi sonrası 6. Haftada 12,02 gr/dl düzeyine yükselmiştir. Tedavi öncesi 34,7 (39) olan fiziksel rol güçlüğü, tedavi sonrasında 54,2 (39,8)’e yükselmiştir (P=0,006). Emosyonel rol güçlüğü, (P=0,330), enerji canlılık (P=0,210) ve ruh sağlığı (P=0,910) alt boyutlarında anlamlı farklılık olmadığı saptanmıştır. 3 hastada minör yan etki gözlenmiştir.
Sonuç: Parenteral demir karboksimaltoz tedavisi özellikle fiziksel rol güçlüğü kategorisinde olmak üzere yaşam kalitesini belirgin şekilde artırmıştır. Bu yüzden demir eksikliği etkili bir şekilde replase edilmelidir.

Keywords

• Demir,Anemi,Yaşam kalitesi,Jinekoloji

The effect of iron carboxymaltose treatment on quality of life in women with iron deficiency

Abstract

Aim: Iron deficiency is the most common cause of anemia in over the world and affects 20% of women, even in developed countries. In this study, our aim is to calculate the change in the quality of life of patients treated with parenteral ferric carboxymaltose.
Methods: In this retrospective cohort study, quality of life scores were evaluated before and after 6 weeks of treatment using the Short Form 36 scale. Fifty patients receiving parenteral ferric carboxymaltose treatment in Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Gynecology and Obstetrics were included.
Results: Pretreatment ad posttreatment hemoglobin values were 8.22 g/dl and 12.02 g/dl, respectively. Pretreatment physical role functioning score was 34.7 (39) and it was calculated as 54.2 (39.8) after the treatment (P=0.006). There were no significant differences between pre- and post-treatment emotional strength, (P=0.330), energy vitality, (P=0.210), mental health (P=0.910) scores and sub-dimensions. Minor side effects were observed in 3 patients.
Conclusion: Parenteral ferric carboxymaltose therapy significantly improves quality of life, especially physical role strength. Iron deficiency should be replaced effectively.

Keywords

• Iron,Anemia,Quality of life,Gynecology

References

1. 1. Frewin R, Henson A, Provan D. Iron deficiency anemia. BMJ. 1997;314:360-3.
2. 2. Beutler E, Lichman MA, Coller BS. Iron deficiency, ed. Williams E, Hematology fifth edition. Philadelphia 1995;4905-511.
3. 3. DeMaeyer E, Adiels-Tegman M. The prevelance of anaemia in the world. World Health Stat Q. 1985;38:302-6.
4. 4. Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. Prevelance of iron deficiency in the United States. JAMA. 1997;227:973-6.
5. 5. Ali R. Demir eksikliği anemisi. In Dolar E. İç hastalıkları 1.B.İstanbul: Nobel Tıp Kitabevleri. 2005.s.553-7.
6. 6. Froessler B, Collingwood J, Hodyl NA, Dekker G. Intravenous ferric carboxymaltose for anaemia in pregnancy. BMC Pregnancy Childbirth. 2014;14:115.
7. 7. 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;110:267-78.
8. 8. Ware JE, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473-83.

9. 9. Kaya BB, İçagasioglu A. Reliability and validity of the Turkish version of short form 36 (SF-36) in patients with rheumatoid arthritis. J Surg Med. 2018;2:11-6.
10. 10. Lee RG. Iron deficiency and iron deficiency anemia Eds: Lee R.G, Bithell C.T, Foerster J: wintrobe’s clinical Hematology 10 th edition,1999. Lea-Febiger. Chapter 34:979-1010.
11. 11. Davas I, Marangoz D, Varolan A, Akyol A, Baksu B. Gebelikte değişik seviyelerdeki anemilerde demir alınımının maternal, doğum ve perinatal sonuçlara etkileri. J Turk Soc Obstet Gynecol. 2008;5:174-81.
12. 12. Bainton DF, Finch CA. The diagnosis of iron deficiency anemia. Am J Med. 1967;37:62-9.
13. 13. Viethen T, Gerhardt F, Dumitrescu D, Knoop BS, Freyhaus H, Rudolph TK, et al. Ferric carboxymaltose improves exercise capacity and quality of life in patients with pulmonary arterial hypertension and iron deficiency: A pilot study. Int J Cardiol. 2014;175:233-9.
14. 14. Çetin M, Eser B, Güven M, Ünal A, Altınbaş M. Oral demir tedavisinde ferro sülfat ve ferrik polimaltoz etkinliğinin karşılaştırılması. THOD. 1999;9;96-100.
15. 15. Khalafallah A, Annemarie H, Anthony C, Fayez H, Emily W, Christine K, et al. A prospective randomised controlled trial of a single intravenous infusion of ferric carboxymaltose, versus single intravenous iron polymaltose or daily oral ferrous sulphate in the treatment of iron deficiency anaemia in pregnancy Treatment of Pregnancy Anaemia. Semin Hematol. 2018;55:223-34.
16. 16. 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 Disorders. 2011;11:4.
17. 17. Bailie GR. Efficacy and safety of ferric carboxymaltose in correcting iron-deficiency anemia: A review of randomized controlled trials across different indications. Arzneimittelforschung. 2010;60:386–98.
18. 18. Breymann C, Gliga F, Bejenariu C, Strizhova N. Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. Int J Gynecol Obstet. 2008;101:67–73.
19. 19. Sanghoon L, Ki-Jin R, Eun SL, Keun HL, Jeong JL, Tak K. 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;45:858-64.