title: Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose.
abstract: OBJECTIVE
  Oral iron substitution has shown to be insufficient for treatment of severe iron deficiency anemia in pregnancy. Ferric carboxymaltose is a new intravenous (i.v.) iron formulation promising to be more effective and as safe as iron sucrose. We aimed to assess side effects and tolerance of ferric carboxymaltose compared to i.v. iron sucrose in pregnant women.
  
  
  METHODS
  We performed a retrospective analysis of 206 pregnant women who were treated either with ferric carboxymaltose or iron sucrose for iron-deficiency anemia with intolerability to oral iron substitution, or insufficient hemoglobin increase after oral iron treatment, or need for rapid hemoglobin reconstitution. Primary endpoint was to evaluate the maternal safety and tolerability. Secondary endpoint was to assess efficacy of the treatment and exclude safety concerns for the fetus.
  
  
  RESULTS
  The incidence of drug-related adverse events was low and mostly mild in both groups. Mild adverse events occurred in 7.8% for ferric carboxymaltose and in 10.7% for iron sucrose. The mean rise of hemoglobin value was 15.4 g/L for ferric carboxymaltose and 11.7 g/L for iron sucrose.
  
  
  CONCLUSIONS
  Ferric carboxymaltose administration in pregnant women is well tolerated and is not associated with any relevant clinical safety concerns. Ferric carboxymaltose has a comparable safety profile to iron sucrose but offers the advantage of a much higher iron dosage at a time reducing the need for repeated applications and increasing patients' comfort. Ferric carboxymaltose is the drug of choice, if i.v. iron treatment becomes necessary in the second or third trimester of pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Insel and University of Bern, Bern, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Christoph
authors.forename: Christine
authors.initials: C
authors.lastname: Schuller
authors.forename: Hanna
authors.initials: H
authors.lastname: Studer
authors.forename: Olivier
authors.initials: O
authors.lastname: Irion
authors.forename: Begoña Martinez
authors.initials: BM
authors.lastname: De Tejada
authors.forename: Daniel
authors.initials: D
authors.lastname: Surbek
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000188:drug therapy*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid / Q000008:administration & dosage*; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D005290:Ferric Compounds; D006397:Hematinics; C522335:ferric carboxymaltose; D008320:Maltose; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid