Ferric carboxymaltose elevates Hb levels in women with iron deficiency anaemia
Intravenous infusions of ferric carboxymaltose (FCM) may increase haemoglobin (Hb) levels in women with iron deficiency anaemia (IDA), according to a study presented at the RCOG World Congress 2018 held in Singapore.
Sixty women with IDA (aged >18 years, Hb level 6–8 g/dL, serum ferritin level <15 ng/mL) were randomized in a 1:1 ratio to receive FCM (two infusions of 500 mg) or iron sucrose complex (ISC; five infusions of 200 mg) intravenously for 2 weeks. IDA was determined in patients using microcytic hypochromic peripheral smear or by low serum ferritin levels, while the Ganzoni formula was used to calculate iron deficit. Patients were followed up every 7, 14, 21, and 28 days. [RCOG 2018, abstract 5808]
At 28 days follow-up, Hb levels increased by 3.17 g/dL from baseline among patients in the FCM treatment arm (n=19).
Compared with women given ISC, those who received FCM had higher Hb (10.14 vs 8.88 g/dL; p=0.001) and serum ferritin levels (147.70 vs 98.03 µg/L; p=0.001).
In addition, mean corpuscular haemoglobin values were also higher among women on FCM compared with ISC at 28 days (33.02 vs 29.32 pg; p=0.001).
More women treated with FCM achieved a normal mean corpuscular volume (≥80.00 fL) compared with those treated with ISC (100 percent, increase from 70.14 to 84.35 fL vs 43.33 percent, increase from 69.94 fL to 78.91 percent) at 28 days of follow-up.
The increase in aspartate transaminase and alanine transaminase levels was comparable between the FCM and ISC treatment groups.
Most women in the ISC treatment group had at least one adverse event. There was a higher incidence of headache and dizziness among women treated with FCM and a significantly lower incidence and severity of thrombophlebitis was observed in women treated with ISC.
“Intravenous FCM is more effective and safer … [for] the treatment of IDA in women,” said lead author Dr Garima Chaudhry from the Department of Obstetrics and Gynaecology at Lady Hardinge Medical College, West Delhi, Delhi, India.“The molecular structure of FCM ensures controlled delivery of iron within cells of reticuloendothelial system and subsequent delivery to the iron binding proteins ferritin and transferrin, with minimal risk of release of large amounts of ionic iron in the serum,” Chaudhry noted.