Gerb Jesse, Strauss William, Derman Richard, Short Vanessa, Mendelson Ben, Bahrain Huzefa, Auerbach Michael
University of Maryland, College Park, MD, USA.
AMAG Pharmaceuticals, Waltham, MA, UK.
Ther Adv Hematol. 2021 May 31;12:20406207211018042. doi: 10.1177/20406207211018042. eCollection 2021.
A litany of recent evidence supports the morbidity of intra-natal iron-deficiency anemia and its prodrome, iron deficiency. Oral iron administered during second and third trimesters does not get to the developing fetus if the mother is iron deficient. This is especially concerning as the rapidly developing fetal brain is in particular need of iron sufficiency. Intra-natal iron deficiency is associated with autism, schizophrenia and abnormal brain structure. The obstetrical literature reports an unacceptably high incidence of gastrointestinal adverse events with oral iron. The time iron honored standard in the United States for intravenous iron replenishment in gravidas is iron sucrose. While safe and effective, four to seven visits are required to accomplish what newer formulations can achieve with one.
Ferumoxytol is a superparamagnetic iron oxide linked to polyglucose sorbitol carboxymethylether-binding elemental iron tightly allowing administration of complete replacement doses in 15-30 min. Herein, we report the results of 131 consecutive, non-selected, iron-deficient second- and third-trimester pregnant women who received either 510 mg of intravenous (IV) ferumoxytol twice or 1020 mg once.
Hemoglobin and iron parameter increments were highly statistically significant. No adverse events were reported. We report how a single infusion is safe and effective as the same dose over two visits, saving an unnecessary visit and IV placement, while reducing cost.
Ferumoxytol represents an efficacious and safe method of administration of IV iron which improves convenience for patients and practitioners, and is cost saving due to fewer visits.
One or two infusions of intravenous iron for iron deficiency or iron-deficiency anemia of pregnancy simplifies careThis study was conducted to highlight the inconvenience of multiple doses of IV iron and how administering the same dose in one or two infusions simplifies care. We report how a single infusion is as safe and effective as the same dose over two visits, saving an unnecessary visit and IV placement, while reducing cost. This study supports a growing body of evidence, to date, unreported, with ferumoxytol in pregnancy, reporting improved convenience and decreased costs with higher doses of IV iron in one or two visits.
近期大量证据表明，产前缺铁性贫血及其前驱症状铁缺乏会引发疾病。如果母亲缺铁，在妊娠中期和晚期口服铁剂无法输送至发育中的胎儿体内。这一点尤其令人担忧，因为快速发育的胎儿大脑特别需要充足的铁。产前缺铁与自闭症、精神分裂症及脑结构异常有关。产科文献报道，口服铁剂导致胃肠道不良事件的发生率高得令人无法接受。在美国，妊娠期静脉补铁的长期标准药物是蔗糖铁。虽然蔗糖铁安全有效，但需要4至7次就诊才能完成新配方一次就能达到的效果。
羧基麦芽糖铁是一种超顺磁性氧化铁，与聚葡萄糖山梨醇羧甲基醚相连，紧密结合元素铁，能够在15至30分钟内给予完全替代剂量。在此，我们报告了131例连续入选的、未经过挑选的缺铁性妊娠中期和晚期孕妇的结果，这些孕妇接受了两次510毫克的静脉注射羧基麦芽糖铁或一次1020毫克的静脉注射羧基麦芽糖铁。
血红蛋白和铁参数的增加具有高度统计学意义。未报告不良事件。我们报告了单次输注与分两次输注相同剂量一样安全有效，节省了不必要的就诊和静脉置管，同时降低了成本。
羧基麦芽糖铁是一种安全有效的静脉补铁给药方法，提高了患者和医护人员的便利性，且因就诊次数减少而节省了费用。
单次或两次静脉输注铁剂治疗孕期缺铁或缺铁性贫血可简化护理
本研究旨在强调多次静脉输注铁剂的不便之处，以及单次或两次输注相同剂量如何简化护理。我们报告了单次输注与分两次输注相同剂量一样安全有效，节省了不必要的就诊和静脉置管，同时降低了成本。本研究支持了越来越多关于羧基麦芽糖铁用于孕期的证据，这些证据迄今尚未报道，表明单次或两次输注高剂量静脉铁剂可提高便利性并降低成本。
