Röhrig Gabriele, Steinmetz Tilmann, Stein Jürgen, Geisel Tabea, Virgin Garth, Schaefer Roland, Bach Matthias, Schulz Ralf-Joachim
MMW Fortschr Med. 2014 Jul 24;156 Suppl 2:48-53.
Anemia in the elderly is a common clinical finding. Prevalence in hospitalized geriatric patients approximates up to 40% presenting as iron deficiency anemia associated with absolute iron deficiency, anemia of chronic disease associated with functional iron deficiency or unexplained anemia. In patients with functional iron deficiency oral iron substitution is ineffective due to elevated hepcidin levels, such as in renal anemia. In these patients intravenous iron substitution represents a cornerstone. However, data among geriatric patients are limited. We conducted three non-interventional studies collecting data with respect to efficacy and tolerance of ferric carboxymaltose (ferinject) in three patient groups (cancer, chronic kidney disease [CKD], chronic inflammatory bowel disease [CIBD]) with anemia and functional iron deficiency. The present sub-analysis describes the results among the geriatric patients (age > 70 years) observed in all three observational studies.
PATIENTS, METHODS: 264 patients were analyzed (mean age of 76.9 years [70-90 years; SD +/- 5.2 years]). Patients received an average amount of 1200 mg ferric carboxymaltose (746-1575 mg).
Hemoglobin levels (p < 0.001), serum ferritin (p < 0.001) and transferrin saturation (p < 0.05) rose significantly in CKD patients; in CIBD patients hemoglobin and transferrin saturation rose significantly (p < 0.05) while the rise of ferritin failed to be significant. In oncologic patients the rise of hemoglobin and ferritin levels was of high statistic significance (p < 0.001) and transferrin saturation also rose significantly (p = 0.02) Fatigue, mental capacities as well as dyspnea improved among CKD-and CIBD-groups. No severe adverse reactions occurred.
Administration of ferric carboxymaltose in geriatric patients is well tolerated and offers an effective treatment option for the treatment of functional iron deficiency.
老年人贫血是常见的临床现象。住院老年患者中的患病率接近40%，表现为与绝对铁缺乏相关的缺铁性贫血、与功能性铁缺乏相关的慢性病贫血或不明原因的贫血。在功能性铁缺乏患者中，由于铁调素水平升高，口服铁剂替代治疗无效，如肾性贫血。在这些患者中，静脉补铁是关键。然而，老年患者的数据有限。我们进行了三项非干预性研究，收集了三组贫血和功能性铁缺乏患者（癌症、慢性肾脏病[CKD]、慢性炎症性肠病[CIBD]）使用羧基麦芽糖铁（费乐必能）的疗效和耐受性数据。本亚组分析描述了在所有三项观察性研究中观察到的老年患者（年龄>70岁）的结果。
患者、方法：分析了264例患者（平均年龄76.9岁[70 - 90岁；标准差±5.2岁]）。患者平均接受1200mg羧基麦芽糖铁（746 - 1575mg）。
CKD患者的血红蛋白水平（p < 0.001）、血清铁蛋白（p < 0.001）和转铁蛋白饱和度（p < 0.05）显著升高；CIBD患者的血红蛋白和转铁蛋白饱和度显著升高（p < 0.05），而铁蛋白升高不显著。肿瘤患者的血红蛋白和铁蛋白水平升高具有高度统计学意义（p < 0.001），转铁蛋白饱和度也显著升高（p = 0.02）。CKD组和CIBD组的疲劳、心理能力以及呼吸困难均有改善。未发生严重不良反应。
老年患者使用羧基麦芽糖铁耐受性良好，为功能性铁缺乏的治疗提供了一种有效的治疗选择。
