Estudio comparativo de 2 formulaciones de hierro intravenoso en una Unidad de Hospital de Día

Abstract

Objectives

To compare effectiveness, efficiency and safety of two parenteral iron formulations in patients with inflammatory bowel disease: ferric-carboximaltose vs ferric-sacarose.

Methods

Retrospective analysis of 72 patients undergoing intravenous iron treatment. Indications of treatment: hemoglobin < 10 g/dL and or ferritininemia < 100 μg/L. The need of transfusion of red blood cells pools was registered, meaning the immediate closure of the follow-up of the patient. Iron protocol administration: ferric-carboximaltose (40 patients): maximum dose 1000 mg in 15 minutes perfusion; ferric-sacarose (32 patients): maximum dose 200 mg in 1 hour perfusion.

Results

There were no significant differences in average levels of haemoglobin (Ferric-carboxymaltose 10.78 ± 2.06 mg/dL vs. Ferric-sucrose 10.14 ± 2.33 mg/dL), haematocrit (ferric-carboxymaltose 32.15 ± 3.24% vs. ferric-sucrose 30.47 ± 4.53%), MCV (ferric-carboxymaltose 72.40 ± 7.72 fL vs. ferric-sucrose 69.54 ± 8.46 fL) and MCH (ferric-carboxymaltose 25.43 ± 6.22 pg/dL vs. ferric-sucrose 23.75 ± 5.93 pg/dL). Average ferritin levels were higher in ferric-carboxymaltose group (246.74 ± 17.83 μg/L vs. 179.52 ± 21.36 μg/L; P=.023).

Adverse events registered in the administration of ferric-carboxymaltose were lower (2 urticarial reactions) vs. al ferric-sucrose (13 stomachache and headache cases); p < 0.001. 2 patients with ferric-carboxymaltose required blood transfusion vs. 6 patients with Ferric-sucrose group; p = 0.062. The number of administered dosages was significantly higher in ferric-sucrose group in a ratio ferric-sucrose/ferric-carboxymaltose of 3.39 dosages/patient. Ferric-carboxymaltose application reduced treatment cost in €948.46/patient.

Conclusions

Treatment with intravenous ferric-carboxymaltose shows an effectiveness profile not inferior to ferric-sucrose. Higher repletion of systemic stock and a better security profile. Related to posology, treatment shows to improve efficiency, reducing dosages, blood transfusion and cost per patient.