与羧基麦芽糖铁相比，静脉注射异麦芽糖铁引发输液反应的发生率更高，且不受稀释体积的影响。
Intravenous administration of ferric derisomaltose is associated with a higher incidence of infusion reactions than ferric carboxymaltose, and unaffected by dilution volume.
作者信息
Lucas Sarah, Chauhan Ayushi, Hurley Ciaran, Xu Calvin, Yu Catherine, Tan Katrina, Taylor Sarah, Suleiman Mani, Leung Teresa, Garg Mayur
机构信息
Department of Gastroenterology, Northern Health, Melbourne, Victoria, Australia.
Research Development and Governance Unit, Northern Health, Melbourne, Victoria, Australia.
出版信息
Intern Med J. 2025 Aug;55(8):1293-1300. doi: 10.1111/imj.70100. Epub 2025 Jun 4.
BACKGROUND
The incidence of and risk factors for infusion-related reactions to intravenous iron formulations remains poorly characterised. This study aimed to compare the rates of infusion reactions in patients receiving ferric derisomaltose (FDI) compared to ferric carboxymaltose (FCM), as well as across different dilutions of FDI.
AIMS
To compare the rates of infusion reactions in patients receiving ferric derisomaltose (FDI) compared to ferric carboxymaltose (FCM), as well as across different dilutions of FDI.
METHODS
This was a single tertiary centre retrospective matched cohort study of patients who received FDI or FCM between January 2022 and May 2023. Reactions were classified as Fishbane or hypersensitivity and characterised by severity using the Ring and Messmer classification.
RESULTS
A total of 660 patients (330 age- and sex-matched patients who received FDI and FCM, respectively) were included. Hypersensitivity reactions occurred in 34 of 330 (10.3%) patients receiving FDI infusions compared to eight of 330 (2.4%) patients receiving FCM (odds ratio (OR), 4.62 (95% confidence interval (CI), 2.10-9.78), P < 0.0001). All reactions to FCM and FDI were classified as mild to moderate except for one grade III reaction to FDI. There was no difference in the rate of reaction between patients receiving FDI diluted in 100 mL (18/165) compared to 250 mL (16/165) sodium chloride (OR, 1.14 (95% CI, 0.55-2.27), P = 0.86). A history of a reaction to an alternative iron formulation was associated with increased risk of infusion reactions (OR, 3.55 (95% CI, 0.67-18.97), P = 0.14) and increasing age was associated with reduced risk (OR, 0.96 (95% CI, 0.94-0.99), P = 0.02).
CONCLUSION
Patients receiving FDI had a significantly higher risk of mild infusion reactions compared to those receiving FCM, with no difference across different dilution volumes of FDI.
背景
静脉注射铁剂相关输注反应的发生率和危险因素仍未得到充分描述。本研究旨在比较接受异麦芽糖铁（FDI）与羧基麦芽糖铁（FCM）的患者的输注反应发生率，以及不同稀释度的FDI之间的反应发生率。
目的
比较接受异麦芽糖铁（FDI）与羧基麦芽糖铁（FCM）的患者的输注反应发生率，以及不同稀释度的FDI之间的反应发生率。
方法
这是一项单中心回顾性匹配队列研究，研究对象为2022年1月至2023年5月期间接受FDI或FCM的患者。反应分为菲什巴内反应或过敏反应，并根据Ring和Messmer分类法对严重程度进行分类。
结果
共纳入660例患者（分别为330例年龄和性别匹配的接受FDI和FCM的患者）。接受FDI输注的330例患者中有34例（10.3%）发生过敏反应，而接受FCM的330例患者中有8例（2.4%）发生过敏反应（优势比（OR）为4.62（95%置信区间（CI）为2.10 - 9.78），P < 0.0001）。除1例FDI的III级反应外，所有对FCM和FDI的反应均分类为轻度至中度。接受100 mL（18/165）与250 mL（16/165）氯化钠稀释的FDI的患者之间的反应发生率无差异（OR为1.14（95%CI为0.55 - 2.27），P = 0.86）。对其他铁剂有反应史与输注反应风险增加相关（OR为3.55（95%CI为0.67 - 18.97），P = 0.14），年龄增加与风险降低相关（OR为0.96（95%CI为0.94 - 0.99），P = 0.02）。
结论
与接受FCM的患者相比，接受FDI的患者发生轻度输注反应的风险显著更高，不同稀释体积的FDI之间无差异。
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