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N001. Comparative study of two intravenous iron formulations in day-hospital: effectiveness, efficiency and security

N. Cano1, L. Oltra1, E. Martín2, E. Hinojosa1, J. Hinojosa1, 1Manises Hospital, Inflammatory Bowel Disease Unit – Day Hospital, Manises, Spain, 2University General Hospital, Valencia, Spain

Background

Iron deficit anemia is a phenomenon usually related to chronic inflammatory bowel disease. Nowadays, several pharmacological formulations have been developed to supply iron deficit, varying in the associated dextran composition. We sought to compare effectiveness, efficiency and security of two intravenous iron formulations concomitantly to basis treatment in patients affected of Crohn's disease and ulcerative colitis: ferric-carboxymaltose (FC) and ferric-sucrose (FS).

Methods

72 patients undergoing intravenous iron treatment enrolled (June 2011 – February 2012). Indications for iron intravenous treatment: haemoglobin <10 g/dL and/or ferritin <100 mcg/L. Exclusion criteria: intravenous iron intolerance and/or undergoing additional oral iron supplementation. Patients undergoing erythropoietin treatment were not excluded. Blood transfusion was registered but meant the exclusion of the patient of the follow-up. Protocol of treatment: Ferric-carboxymaltose (40 patients): 1000 mg in 15 minutes perfusion once a week; ferric-sucrose (32 patients): 200 mg in 2 hours perfusion twice a week. Variables considered: average haemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), ferritin, number of dosages, cost of the treatment and tolerance/adverse events.

Results

There were no significant differences in average levels of haemoblobin (FC 10.78±2.06 mg/dL vs. FS 10.14±2.33 mg/dL), hematocrit (FC 32.15±3.24% vs. FS 30.47±4.53%), MCV (FC 72.40±7.72 fL vs. FS 69.54±8.46 fL) and MCH (FC 25.43±6.22 pg/dL vs. FS 23.75±5.93 pg/dL). Average ferritin levels were higher in FC group (264.74±17.83 mcg/L vs. 179.52±21.36 mcg/L; p = 0.023). Adverse events registered in the administration of FC were lower (1.44% (2) urticarial reactions) vs. FS (6.10% (23) stomachache/headache); p < 0.001. 2 patients in FC group required blood transfusion vs. 6 patients in FS group; p = 0.062. The number of administered dosages was significantly higher in FS group in a ratio FS/FC of 3.39 dosages per patient. FC application reduced treatment cost in 948.46 euros per patient.

Conclusion

Treatment with intravenous FC for concomitant treatment of iron deficit anaemia in patients with chronic inflammatory bowel disease, shows an effectiveness profile not inferior to FS, with higher increase of ferritin levels and a better security profile. Related to its posology, FC treatment shows to improve efficiency reducing dosages, blood transfusion and costs per patient.