Gybel-Brask Mikkel, Seeberg Jens, Thomsen Lars L, Johansson Pär I
Section for Transfusion Medicine, Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Aalborg University, Aalborg, Denmark.
Transfusion. 2018 Apr;58(4):974-981. doi: 10.1111/trf.14521. Epub 2018 Feb 9.
This trial evaluated the efficacy and safety of intravenous (IV) iron isomaltoside (Monofer) in comparison with placebo in first-time female blood donors.
The trial was a prospective, double blind, placebo-controlled, randomized, comparative, single-center trial of 85 first-time female blood donors. The subjects were randomly assigned 1:1 to either 1000 mg IV iron isomaltoside infusion or placebo. The primary endpoint of the trial was change in hemoglobin (Hb) from baseline to right before the third blood donation.
The increase in Hb was significantly higher for iron isomaltoside compared with placebo right before both the second blood donation (p = 0.0327) and the third blood donation (primary endpoint, p < 0.0001). Improvements in other iron-related variables (plasma iron, plasma ferritin, transferrin saturation, and reticulocyte count) in favor of iron isomaltoside were also observed. The trial was not powered on patient-reported outcomes. However, improvements in iron stores and Hb levels after iron isomaltoside administration were supported by the fact that several of the fatigue symptoms scores showed numerical differences in favor of iron isomaltoside. There were no differences in side effects between the groups.
In iron-deficient female blood donors a single IV iron isomaltoside administration resulted in an improvement in Hb concentration and iron stores and demonstrated a favorable safety profile comparable to placebo.
本试验评估了异麦芽糖酐铁静脉注射剂(莫诺菲)与安慰剂相比,在首次献血女性中的疗效和安全性。
该试验是一项前瞻性、双盲、安慰剂对照、随机、比较性、单中心试验,纳入了85名首次献血的女性。受试者按1:1随机分配接受1000mg异麦芽糖酐铁静脉输注或安慰剂。试验的主要终点是从基线到第三次献血前血红蛋白(Hb)的变化。
在第二次献血前(p = 0.0327)和第三次献血前(主要终点,p < 0.0001),异麦芽糖酐铁组的Hb升高均显著高于安慰剂组。还观察到其他铁相关变量(血浆铁、血浆铁蛋白、转铁蛋白饱和度和网织红细胞计数)向有利于异麦芽糖酐铁的方向改善。该试验未对患者报告的结局进行功效分析。然而,异麦芽糖酐铁给药后铁储存和Hb水平的改善得到了以下事实的支持:一些疲劳症状评分在数值上显示有利于异麦芽糖酐铁。两组之间的副作用无差异。
在缺铁的女性献血者中,单次静脉注射异麦芽糖酐铁可使Hb浓度和铁储存得到改善,并显示出与安慰剂相当的良好安全性。