Interdisciplinary Crohn Colitis Centre Rhein-Main, Frankfurt/Main, Germany.
Department of Gastroenterology and Clinical Nutrition, DGD Clinics Sachsenhausen, Frankfurt/Main, Germany.
J Crohns Colitis. 2018 Jun 28;12(7):826-834. doi: 10.1093/ecco-jcc/jjy042.
Iron deficiency and iron deficiency anaemia are common complications in inflammatory bowel disease [IBD] patients. Anaemia in IBD is attributable to chronic blood loss and/or impaired iron intake and absorption. International guidelines recommend intravenous iron supplementation in IBD patients, since oral supplements are frequently poorly tolerated and can exacerbate inflammation. Intravenous ferric carboxymaltose [FCM; Ferinject® 50 mg ferric iron[III]/mL suspension] was approved in Europe in 2007 for correction of iron deficiency, and can be administered in single 15-min infusions of up to 1000 mg.
A prospective non-interventional post-marketing study was performed in 101 centres in Germany to assess the efficacy, tolerability, and convenience of Ferinject® in clinical practice in a large cohort of IBD patients. Primary endpoints were haemoglobin [Hb] normalisation or increase ≥2 g/dL [responders], and normalisation of serum ferritin [s-ferritin] and transferrin saturation. Adverse events [AEs], clinical signs/symptoms, and disease activity indices were also analysed.
In all, 224 subjects (127 Crohn's disease [CD]; 97 ulcerative colitis [UC]) were treated. Mean total iron dose was 1139 mg [range: 100 mg-4800 mg], with 76.7% of doses between 500 mg and 2000 mg; 63.3% of patients responded, and no adverse drug reactions or drug-attributed serious adverse events [SAEs] or deaths occurred. Mean increases of Hb [10.0 to 12.3 g/dL], ferritin [52 μg/L to 103 μg/L], transferrin saturation [TSAT, 15% to 25%], and s-iron [6.1 to 12.4 μmol/L] were significant [p = 0.0001]. Clinical scores and quality of life improved due to the amelioration of anaemia symptoms.
Ferinject®-therapy was proven to be effective and safe in a large cohort of patients with IBD-associated anaemia in routine practice. Rapid, high-dose application is convenient for physicians and reduces patients' time lost from work.
缺铁和缺铁性贫血是炎症性肠病(IBD)患者常见的并发症。IBD 中的贫血归因于慢性失血和/或铁摄入和吸收受损。国际指南建议 IBD 患者使用静脉铁补充剂,因为口服补充剂通常耐受性差,并可能加重炎症。静脉注射羧麦芽糖铁[FCM;Ferinject®50mg 三价铁[III]/mL 混悬液]于 2007 年在欧洲获批用于纠正缺铁,可以单次 15 分钟输注高达 1000mg。
在德国的 101 个中心进行了一项前瞻性非干预性上市后研究,以评估 Ferinject®在 IBD 患者大队列中的临床实践中的疗效、耐受性和便利性。主要终点是血红蛋白[Hb]正常化或增加≥2g/dL[应答者],以及血清铁蛋白[s-铁蛋白]和转铁蛋白饱和度正常化。还分析了不良事件[AE]、临床体征/症状和疾病活动指数。
共有 224 名受试者(127 名克罗恩病[CD];97 名溃疡性结肠炎[UC])接受了治疗。总铁剂量平均为 1139mg[范围:100mg-4800mg],500mg-2000mg 之间的剂量占 76.7%;63.3%的患者有反应,没有药物不良反应或药物相关的严重不良事件[SAE]或死亡。Hb[10.0 至 12.3g/dL]、铁蛋白[52μg/L 至 103μg/L]、转铁蛋白饱和度[TSAT,15%至 25%]和 s-铁[6.1 至 12.4μmol/L]的平均增加均具有统计学意义[p=0.0001]。由于贫血症状的改善,临床评分和生活质量得到改善。
Ferinject®治疗在常规实践中在患有 IBD 相关贫血的大型患者队列中被证明是有效和安全的。快速、高剂量的应用对医生来说很方便,并减少了患者因工作而失去的时间。