Friedrisch João Ricardo, Cançado Rodolfo Delfini
Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.
Rev Bras Hematol Hemoter. 2015 Nov-Dec;37(6):400-5. doi: 10.1016/j.bjhh.2015.08.012. Epub 2015 Oct 14.
Nutritional iron deficiency anemia is the most common deficiency disorder, affecting more than two billion people worldwide. Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia, but in many conditions, oral iron is less than ideal mainly because of gastrointestinal adverse events and the long course needed to treat the disease and replenish body iron stores. Intravenous iron compounds consist of an iron oxyhydroxide core, which is surrounded by a carbohydrate shell made of polymers such as dextran, sucrose or gluconate. The first iron product for intravenous use was the high molecular weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to use intravenous iron for the treatment of iron deficiency anemia over many years. Intravenous ferric carboxymaltose is a stable complex with the advantage of being non-dextran-containing and a very low immunogenic potential and therefore not predisposed to anaphylactic reactions. Its properties permit the administration of large doses (15mg/kg; maximum of 1000mg/infusion) in a single and rapid session (15-minute infusion) without the requirement of a test dose. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, and safety profile of ferric carboxymaltose in the treatment of patients with iron deficiency anemia.
营养性缺铁性贫血是最常见的营养缺乏症，全球有超过20亿人受其影响。口服铁剂补充通常是治疗缺铁性贫血的首选方法，但在许多情况下，口服铁剂并不理想，主要原因是胃肠道不良事件以及治疗疾病和补充体内铁储备所需的疗程较长。静脉用铁化合物由氢氧化铁核心组成，其周围是由右旋糖酐、蔗糖或葡萄糖酸盐等聚合物制成的碳水化合物外壳。首个静脉用铁产品是高分子量右旋糖酐铁。然而，含右旋糖酐的静脉用铁制剂与过敏反应风险升高有关，这使得医生在多年时间里都不愿使用静脉用铁来治疗缺铁性贫血。静脉用羧麦芽糖铁是一种稳定的复合物，具有不含右旋糖酐且免疫原性极低的优点，因此不易引发过敏反应。其特性允许在单次快速给药（15分钟输注）时给予大剂量（15mg/kg；最大1000mg/次输注），无需试验剂量。本综述的目的是讨论与羧麦芽糖铁治疗缺铁性贫血患者的历史、药理学、给药方法、疗效和安全性相关的一些相关问题。
