Gómez-Ramírez Susana, Brilli Elisa, Tarantino Germano, Girelli Domenico, Muñoz Manuel
Department of Internal Medicine, University Hospital "Virgen de la Victoria", 29010 Málaga, Spain.
Scientific Department, Alesco S.r.l., Via delle Lenze, 56122 Pisa, Italy.
Pharmaceuticals (Basel). 2023 Jun 6;16(6):847. doi: 10.3390/ph16060847.
Iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent worldwide. Oral iron salts, especially ferrous sulfate, are commonly used for the treatment of iron deficiency (ID). However, its use is associated with gastrointestinal side effects, thus compromising treatment compliance. Intravenous iron administration is a more costly and logistically complex alternative and is not risk-free, as infusion and hypersensitivity reactions may occur. Sucrosomial iron is an oral formulation consisting of ferric pyrophosphate conveyed by a phospholipid and sucrester matrix (sucrosome). Intestinal Sucrosomial iron absorption is mediated by enterocytes and M cells, through the paracellular and transcellular routes, and occurs mostly as intact particles. These pharmacokinetic properties of Sucrosomial iron result in higher iron intestinal absorption and excellent gastrointestinal tolerance compared to oral iron salts. The evidence derived from clinical studies supports the use of Sucrosomial iron as a valid first option for the treatment of ID and IDA, especially for subjects who are intolerant or refractory to conventional iron salts. Newer evidence also demonstrates the effectiveness of Sucrosomial iron, with a lower cost and fewer side effects, in certain conditions usually treated with IV iron in current clinical practice.
缺铁(ID)和缺铁性贫血(IDA)在全球范围内高度流行。口服铁盐,尤其是硫酸亚铁,常用于治疗缺铁(ID)。然而,其使用会带来胃肠道副作用,从而影响治疗依从性。静脉注射铁剂是一种成本更高且在后勤方面更为复杂的替代方法,并且并非没有风险,因为可能会发生输液和过敏反应。蔗糖铁是一种口服制剂,由焦磷酸铁通过磷脂和蔗糖酯基质(蔗糖体)输送而成。肠道对蔗糖铁的吸收由肠上皮细胞和M细胞介导,通过细胞旁和跨细胞途径进行,并且大多以完整颗粒的形式发生。与口服铁盐相比,蔗糖铁的这些药代动力学特性导致肠道铁吸收更高且胃肠道耐受性良好。临床研究得出的证据支持将蔗糖铁作为治疗ID和IDA的有效首选方案,尤其是对于那些对传统铁盐不耐受或难治的患者。最新证据还表明,在当前临床实践中通常用静脉注射铁剂治疗的某些情况下,蔗糖铁具有疗效,成本更低且副作用更少。