Auerbach Hematology and Oncology, 9110 Philadelphia Road Suite 314, Baltimore, Maryland, 21237.
Am J Hematol. 2013 Nov;88(11):944-7. doi: 10.1002/ajh.23534. Epub 2013 Sep 9.
For the majority of patients with iron deficiency anemia (IDA), a full course of intravenous (IV) iron is 1 g. Most IV irons require 5-10 administrations of 100-300 mg. We have successfully employed 1 g low molecular weight iron dextran over 1 hr. For further convenience for patients and physicians, we explored the administration of 1.02 g of ferumoxytol over 15 min instead of the approved 2 × 510 mg injections. Sixty patients with IDA, (hemoglobin <11 g/dL, transferrin saturation [TSAT] ≤20%, and ferritin <100 ng/mL) with an inadequate response or intolerance to oral iron, received 1020 mg ferumoxytol over 15 min. Vital signs were measured for 1 hr. Adverse events (AEs) were collected via telephone at 1, 2, and 7 days. Follow-up visits occurred at 4 and 8 weeks for efficacy assessments. The primary endpoint was safety and tolerability. Secondary efficacy endpoints included mean change in hemoglobin, TSAT, and red cell distribution width. No serious adverse events (SAEs) occurred. Fifty-eight patients received the planned dose. Twenty-six out of sixty (43.3%) patients reported AEs of which 13 were mild and transient during infusion. All resolved within minutes. Fourteen patients reported self-limited arthralgias, myalgias, and/or headache within 24-48 hr. At Baseline, the mean hemoglobin was 9.4 g/dL. The mean increments at Week 4 and 8 were 2.1 and 2.6 g/dL, respectively. Ferumoxytol, administered as 1.02 g infusion over 15 min was well tolerated with no SAEs and demonstrated excellent efficacy. If corroborated in future studies this represents an improved method of treating IDA.
对于大多数缺铁性贫血(IDA)患者,一个完整的静脉(IV)铁疗程为 1 克。大多数 IV 铁需要 5-10 次 100-300 毫克的给药。我们已经成功地在 1 小时内使用了 1 克低分子右旋糖酐铁。为了进一步方便患者和医生,我们探索了在 15 分钟内给予 1.02 克ferumoxytol,而不是批准的 2×510mg 注射。60 例 IDA 患者(血红蛋白<11g/dL,转铁蛋白饱和度[TSAT]≤20%,铁蛋白<100ng/mL)对口服铁剂反应不足或不耐受,接受 1020mg ferumoxytol 在 15 分钟内给药。在 1 小时内测量生命体征。通过电话在 1、2 和 7 天收集不良事件(AE)。在第 4 和第 8 周进行疗效评估时进行随访。主要终点是安全性和耐受性。次要疗效终点包括血红蛋白、TSAT 和红细胞分布宽度的平均变化。无严重不良事件(SAE)发生。58 例患者接受了计划剂量。60 例患者中有 26 例(43.3%)报告了 AE,其中 13 例在输注过程中为轻度且短暂。所有症状均在几分钟内缓解。14 例患者报告在 24-48 小时内出现自限性关节痛、肌痛和/或头痛。在基线时,平均血红蛋白为 9.4g/dL。第 4 周和第 8 周的平均增加值分别为 2.1 和 2.6g/dL。1.02g ferumoxytol 在 15 分钟内输注耐受性良好,无 SAE,疗效极佳。如果在未来的研究中得到证实,这代表了一种治疗 IDA 的改进方法。