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静脉注射蔗糖铁治疗成人缺铁性贫血的疗效和安全性。

Efficacy and safety of intravenous iron sucrose in treating adults with iron deficiency anemia.

作者信息

Cançado Rodolfo Delfini, de Figueiredo Pedro Otavio Novis, Olivato Maria Cristina Albe, Chiattone Carlos Sérgio

机构信息

Hematology-Oncology Department, Faculdade de Ciências Médicas da Santa Casa de São Paulo - FCMSCSP, São Paulo, SP, Brazil.

出版信息

Rev Bras Hematol Hemoter. 2011;33(6):439-43. doi: 10.5581/1516-8484.20110119.

Abstract

BACKGROUND

Iron deficiency is the most common disorder in the world, affecting approximately 25% of the world`s population and the most common cause of anemia.

OBJECTIVE

To evaluate the efficacy and safety of intravenous iron sucrose (IS) in the treatment of adults with iron deficiency anemia

METHODS

Eighty-six adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient

RESULTS

The mean hemoglobin and serum ferritin levels were 8.54 g/dL and 7.63 ng/mL (pre-treatment) and 12.1 g/dL and 99.0 ng/mL (post-treatment) (p-value < 0.0001), respectively. The average increases in hemoglobin levels were 3.29 g/dL for women and 4.58 g/dL for men; 94% of male and 84% of female patients responded (hemoglobin increased by at least 2 g/dL) to intravenous iron therapy. Correction of anemia was obtained in 47 of 69 (68.1%) female patients and in 12 of 17 male (70.6%) patients. A total of 515 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with no moderate or serious adverse drug reactions recorded by the investigators.

CONCLUSIONS

Our data confirm that the use of intravenous iron sucrose is a safe and effective option in the treatment of adult patients with iron deficiency anemia who lack satisfactory response to oral iron therapy. Intravenous iron sucrose is well tolerated and with a clinically manageable safety profile when using appropriate dosing and monitoring. The availability of intravenous iron sucrose would potentially improve compliance and thereby reduce morbidities from iron deficiency.

摘要

背景

缺铁是全球最常见的疾病,影响着约25%的世界人口,也是贫血最常见的原因。

目的

评估静脉注射蔗糖铁(IS)治疗成人缺铁性贫血的疗效和安全性。

方法

86例口服铁剂治疗不耐受或无效的成人缺铁性贫血患者,每周静脉注射200mg蔗糖铁,直至血红蛋白水平恢复正常或达到为每位患者计算的静脉铁剂总剂量。

结果

治疗前平均血红蛋白和血清铁蛋白水平分别为8.54g/dL和7.63ng/mL,治疗后分别为12.1g/dL和99.0ng/mL(p值<0.0001)。女性血红蛋白水平平均升高3.29g/dL,男性为4.58g/dL;94%的男性和84%的女性患者对静脉铁剂治疗有反应(血红蛋白至少升高2g/dL)。69例女性患者中有47例(68.1%)、17例男性患者中有12例(70.6%)贫血得到纠正。共进行了515次蔗糖铁静脉输注,蔗糖铁总体耐受性良好,研究人员未记录到中度或严重的药物不良反应。

结论

我们的数据证实,对于口服铁剂治疗反应不佳的成人缺铁性贫血患者,静脉注射蔗糖铁是一种安全有效的治疗选择。使用适当的剂量并进行监测时,静脉注射蔗糖铁耐受性良好,且具有临床可控的安全性。静脉注射蔗糖铁的可用性可能会提高依从性,从而降低缺铁相关的发病率。

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Individualized treatment for iron-deficiency anemia in adults.成人缺铁性贫血的个体化治疗
Am J Med. 2008 Nov;121(11):943-8. doi: 10.1016/j.amjmed.2008.07.012.
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