Reed John, Charytan Chaim, Yee Jerry
Fresenius Medical Care-North America, Clinics of Southeast, Columbus, Mississippi 39705, USA.
Consult Pharm. 2007 Mar;22(3):230-8. doi: 10.4140/tcp.n.2007.230.
This study was undertaken to assess the safety and tolerability of the use of intravenous (IV) iron sucrose in the therapy of iron-deficiency anemia in elderly, hemodialysis dependent (HDD), chronic kidney disease (CKD) patients.
This was a multicenter, open-label study in a large consecutive sample of 665 HDD-CKD patients (in 11 locations). Patients received IV iron sucrose therapy in treatment and maintenance dosing cycles over 10-week periods. There were 10 doses of 100 mg of iron sucrose in each drug cycle, and participants could receive multiple cycles of either or both regimens. Variables evaluated in the intent-to-treat population included adverse events (AEs), hemoglobin, and iron indices.
Of the 665 patients, 391 patients were under the age of 65 (younger adults) and 274 were 65 years of age or older (elder adults). Iron needs and erythropoietin dosing were similar in both the elder and younger adult patients. The incidence, severity, and nature of AEs and overall mortality were similar in both age groups. There were no drug-related deaths or drug-related serious AEs in either group. There were no hypersensitivity reactions or allergic reactions in either patient population, even among those with a prior history of intolerance to other parenteral-iron products. Comparison of the two age groups also revealed no differences in the efficacy of iron treatment as reflected by hemoglobin, transferring saturation, and ferritin response.
There is no apparent difference in the safety and efficacy of iron sucrose between elder and younger adults in the treatment of iron-deficiency anemia in HDD patients with CKD.
本研究旨在评估静脉注射蔗糖铁用于治疗老年、依赖血液透析(HDD)的慢性肾脏病(CKD)患者缺铁性贫血的安全性和耐受性。
这是一项在11个地点对665例HDD-CKD患者的大样本连续病例进行的多中心开放标签研究。患者在10周期间接受治疗和维持剂量周期的静脉注射蔗糖铁治疗。每个药物周期有10剂100mg蔗糖铁,参与者可以接受一种或两种方案的多个周期治疗。在意向性治疗人群中评估的变量包括不良事件(AE)、血红蛋白和铁指标。
665例患者中,391例年龄在65岁以下(年轻成年人),274例年龄在65岁及以上(老年成年人)。老年和年轻成年患者的铁需求和促红细胞生成素剂量相似。两个年龄组的AE发生率、严重程度和性质以及总死亡率相似。两组均无药物相关死亡或药物相关严重AE。两组患者均未发生超敏反应或过敏反应,即使是那些既往对其他胃肠外铁产品不耐受的患者。两个年龄组的比较还显示,在血红蛋白、转铁蛋白饱和度和铁蛋白反应所反映的铁治疗疗效方面没有差异。
在治疗患有CKD的HDD患者缺铁性贫血时,老年和年轻成年人使用蔗糖铁的安全性和疗效没有明显差异。