Öz
Background: Ferric carboxymaltose (FCM) has been an alternative to blood transfusion because of its practical use, rapid effect and no serious advers events (sAE). In this article, we aimed to evaluate patients who received FCM.
Materials and Methods: 185 patients who were followed up in Gastroenterology and Internal Medicine Clinics of Harran University Medical Faculty Hospital between January 2018 and July 2020 were evaluated retrospectively. Diagnosis, laboratory results, blood transfusion and hemoglobin (hb) values were investi-gated before and after FCM theraphy.
Results: 113 (61%) of 185 patients had iron deficiency anemia (IDA), 40 (21%) gastrointestinal system (GIS) bleeding, 16 (9%) inflammatory bowel disease (IBD), 5 liver cirrhosis (3%), 11 (6%) were other diseases. 129 patients (70%) were female and the mean age was 41.45 ± 17.7 (range 17 to 93) years. While the mean hb before FCM was 9.21 ± 1.82 (4.37 - 13.9) g / dl in all patients, the mean hb values of 92 patients reached after 2 weeks were 11.68 ± 1.64 (6.26 - 15.5) g / dl (p< 0.05). Of the 49 patients (27% of all patients) who received erythrocyte suspension (ES). ES was given to 23 (58%) of 40 patients with GI bleeding, 21 (18%) of 113 patients with IDA, 3 (6%) of 5 patients with cirrhosis and 2 (12%) of 16 patients with IBD. In none of the patients, FCM infusion was discontinued due to sEA and no sEA was observed.
Conclusions: Approximately two-thirds of the patients were treated with IDA, one-third with GIS hemorr-hage and IBS, especially GIS bleeding, and one-third of patients received blood transfusion. FCM signifi-cantly increased hb values by 2.5 g / dl in 2 weeks all patients. The greatest need for blood transfusion was in patients with GI bleeding, whereas in other patients, FCM was generally sufficient. FCM infusion did not cause sEA in any patient.
Keywords: Ferriccarboxymaltose, Iron deficiency anemia, gastrointestinal bleeding, Inflammatory bowel disease
Anahtar Kelimeler
ferriccarboxymaltose iron deficiency anemia gastrointestinal bleeding inflammatory bowel disease
Kaynakça
- 1. Keating GM. Ferric carboxymaltose: a review of its use in iron deficiency. Drugs. 2015 Jan;75(1):101-27. doi: 10.1007/s40265-014-0332-3. PMID: 25428711.
- 2. Cappellini MD, Comin-Colet J, de Francisco A, Dignass A, Doehner W, Lam CS, et al; IRON CORE Group. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management. Am J Hematol. 2017 Oct;92(10):1068-1078. doi: 10.1002/ajh.24820. Epub 2017 Jul 7. PMID: 28612425; PMCID: PMC5599965.
- 3. Scott LJ. Ferric Carboxymaltose: A Review in Iron Deficiency. Drugs. 2018 Mar;78(4):479-493. doi: 10.1007/s40265-018-0885-7. PMID: 29532438.
- 4. World Health Organisation. Worldwide Prevalence of Anaemia 1993e2005. WHO, 2008.
- 5. Eritrosit Hastalıkları Ve Hemoglobin Bozuklukları Tanı Ve Tedavi Kılavuzu Eylül 2019, Türk Hematoloji Derneği http://thd.org.tr/thdData/userfiles/file/Ertitrosit-Tani-ve-tedavi-Kilavuzu-2019.pdf
- 6. Lyseng-Williamson KA, Keating GM. Ferric carboxymaltose: a review of its use in iron-deficiency anaemia. Drugs. 2009;69(6):739-56. doi: 10.2165/00003495-200969060-00007. PMID: 19405553.
- 7. Ballester-Clau R, Torres Vicente G, Cucala Ramos M, Aracil Blanch C, Miñana Calafat JM, Pijoan Comas E, et al. Efficacy and Safety of Treatment With Ferric Carboxymaltose in Patients With Cirrhosis and Gastrointestinal Bleeding. Front Med (Lausanne). 2020 Apr 17;7:128. doi: 10.3389/fmed.2020.00128. PMID: 32363194; PMCID: PMC7181670.
- 8. Avni T, Bieber A, Grossman A, Green H, Leibovici L, Gafter-Gvili A. The safety of intravenous iron preparations: systematic review and meta-analysis. Mayo Clin Proc. 2015 Jan;90(1):12-23. doi: 10.1016/j.mayocp.2014.10.007. Epub 2014 Oct 30. PMID: 25572192.
- 9. Ferinject®. Summary of Product Characteristics. www.medicines. Org.
- 10. Blumenstein I, Dignass A, Vollmer S, Klemm W, Weber-Mangal S, Stein J. Current practice in the diagnosis and management of IBD-associated anaemia and iron deficiency in Germany: the German AnaemIBD Study. J Crohns Colitis. 2014 Oct;8(10):1308-14. doi: 10.1016/j.crohns.2014.03.010. Epub 2014 Apr 8. PMID: 24721157.
- 11. Kaur R, Kant S, Haldar P, Ahamed F, Singh A, Dwarakanathan V, et al. Single Dose of Intravenous Ferric Carboxymaltose Prevents Anemia for 6 Months among Moderately or Severely Anemic Postpartum Women: A Case Study from India. Curr Dev Nutr. 2021 Jul 8;5(7):nzab078. doi: 10.1093/cdn/nzab078. PMID: 34268465; PMCID: PMC8275451.
- 12. Barish CF, Koch T, Butcher A, Morris D, Bregman DB. Safety and Efficacy of Intravenous Ferric Carboxymaltose (750 mg) in the Treatment of Iron Deficiency Anemia: Two Randomized, Controlled Trials. Anemia. 2012;2012:172104. doi: 10.1155/2012/172104. Epub 2012 Sep 10. PMID: 22997572; PMCID: PMC3444829.
Öz
Giriş: Demir karboksimaltoz (DKM) parenteral pratik kullanımı, hızlı etki etmesi, ciddi reaksiyonlara neden olmaması nedeniyle kan transfüzyonuna alternatif olmuştur. Bu yazıda DKM verilen hastaların değerlendirilmesi amaçlanmıştır.
Materyal metod: Ocak 2018 – Haziran 2020 tarihleri arasında Harran Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji ve İç Hastalıkları kliniklerinde takip edilen, DKM verilen hastalar retrospektif olarak değerlendirildi. Hastaların tanıları, laboratuvar sonuçları, kan transfüzyonu yapılıp yapılmadığı, DKM öncesi ve ikinci hafta hemoglobin (hb) değerleri araştırıldı.
Bulgular: Toplam 185 hastanın 113’ü (%61) demir eksikliği anemisi (DEA), 40’ı (%21) gastrointestinal sistem (GİS) kanama, 16’sı (%9) inflamatuvar barsak hastalığı (İBH), 5’i (%3) karaciğer sirozu, 11’i (%6) diğer hastalıklar idi. Hastaların 129`u (%70) kadın, yaş ortalaması 41.45 ± 17.7 (dağılım 17 – 93) yaş idi. Tüm hastalarda DKM öncesi ortalama hb 9.21 ± 1.82 (4.37 – 13.9) g/dl iken, 2 hafta sonraki hb değerlerine ulaşılan 92 hastada ortalama hb 11.68 ± 1.64 (6.26 – 15.5) g/dl (p<0.05) idi. GİS kanamalı 40 hastadan 23’ne (%58), DEA’li 113 hastadan 21’ine (%18), sirotik 5 hastadan 3’ne (%6), İBH’lı 16 hastadan 2’sine (%12), toplam 49 hastaya ek olarak eritrosit süspansiyonu (ES) verilmişti. Hastaların hiçbirinde yan etki nedeniyle DKM infüzyonu yarıda bırakılmamış ve ciddi yan etki görülmemiştir.
Sonuç: Hastaların yaklaşık üçte ikisine DEA, üçte biri başta GİS kanama ve İBH olmak üzere GİS hastalıkları nedeniyle DKM verilmiş, hastaların üçte birine kan transfüzyonu da yapılmıştır. DKM tüm hastalarda hb değerlerini 2 hafta içerisinde yaklaşık 2.5 g/dl, arttırarak anlamlı olarak yükseltmiştir. En fazla kan transfüzyonu ihtiyacı GİS kanamalı hastalarda olurken diğer hastalarda genelde DKM yeterli olmuştur. DKM infüzyonu hiçbir hastada ciddi yan etkiye neden olmamıştır.
Anahtar Kelimeler
demir karboksimaltoz demir eksikliği anemisi gastrointestinal sistem kanama inflamatuvar barsak hastalığı
Kaynakça
- 1. Keating GM. Ferric carboxymaltose: a review of its use in iron deficiency. Drugs. 2015 Jan;75(1):101-27. doi: 10.1007/s40265-014-0332-3. PMID: 25428711.
- 2. Cappellini MD, Comin-Colet J, de Francisco A, Dignass A, Doehner W, Lam CS, et al; IRON CORE Group. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management. Am J Hematol. 2017 Oct;92(10):1068-1078. doi: 10.1002/ajh.24820. Epub 2017 Jul 7. PMID: 28612425; PMCID: PMC5599965.
- 3. Scott LJ. Ferric Carboxymaltose: A Review in Iron Deficiency. Drugs. 2018 Mar;78(4):479-493. doi: 10.1007/s40265-018-0885-7. PMID: 29532438.
- 4. World Health Organisation. Worldwide Prevalence of Anaemia 1993e2005. WHO, 2008.
- 5. Eritrosit Hastalıkları Ve Hemoglobin Bozuklukları Tanı Ve Tedavi Kılavuzu Eylül 2019, Türk Hematoloji Derneği http://thd.org.tr/thdData/userfiles/file/Ertitrosit-Tani-ve-tedavi-Kilavuzu-2019.pdf
- 6. Lyseng-Williamson KA, Keating GM. Ferric carboxymaltose: a review of its use in iron-deficiency anaemia. Drugs. 2009;69(6):739-56. doi: 10.2165/00003495-200969060-00007. PMID: 19405553.
- 7. Ballester-Clau R, Torres Vicente G, Cucala Ramos M, Aracil Blanch C, Miñana Calafat JM, Pijoan Comas E, et al. Efficacy and Safety of Treatment With Ferric Carboxymaltose in Patients With Cirrhosis and Gastrointestinal Bleeding. Front Med (Lausanne). 2020 Apr 17;7:128. doi: 10.3389/fmed.2020.00128. PMID: 32363194; PMCID: PMC7181670.
- 8. Avni T, Bieber A, Grossman A, Green H, Leibovici L, Gafter-Gvili A. The safety of intravenous iron preparations: systematic review and meta-analysis. Mayo Clin Proc. 2015 Jan;90(1):12-23. doi: 10.1016/j.mayocp.2014.10.007. Epub 2014 Oct 30. PMID: 25572192.
- 9. Ferinject®. Summary of Product Characteristics. www.medicines. Org.
- 10. Blumenstein I, Dignass A, Vollmer S, Klemm W, Weber-Mangal S, Stein J. Current practice in the diagnosis and management of IBD-associated anaemia and iron deficiency in Germany: the German AnaemIBD Study. J Crohns Colitis. 2014 Oct;8(10):1308-14. doi: 10.1016/j.crohns.2014.03.010. Epub 2014 Apr 8. PMID: 24721157.
- 11. Kaur R, Kant S, Haldar P, Ahamed F, Singh A, Dwarakanathan V, et al. Single Dose of Intravenous Ferric Carboxymaltose Prevents Anemia for 6 Months among Moderately or Severely Anemic Postpartum Women: A Case Study from India. Curr Dev Nutr. 2021 Jul 8;5(7):nzab078. doi: 10.1093/cdn/nzab078. PMID: 34268465; PMCID: PMC8275451.
- 12. Barish CF, Koch T, Butcher A, Morris D, Bregman DB. Safety and Efficacy of Intravenous Ferric Carboxymaltose (750 mg) in the Treatment of Iron Deficiency Anemia: Two Randomized, Controlled Trials. Anemia. 2012;2012:172104. doi: 10.1155/2012/172104. Epub 2012 Sep 10. PMID: 22997572; PMCID: PMC3444829.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Aralık 2022 |
| Gönderilme Tarihi | 4 Mart 2022 |
| Kabul Tarihi | 29 Temmuz 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 19 Sayı: 3 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty