title: Effectiveness and safety of ferric carboxymaltose treatment in children and adolescents with inflammatory bowel disease and other gastrointestinal diseases.
abstract: BACKGROUND
  The treatment of iron deficiency anemia in children with inflammatory bowel disease is a particular challenge and often insufficient. Absorption of orally given iron may be impaired by intestinal inflammation and treatment with oral iron may aggravate intestinal inflammation. This retrospective study is the first to describe the use of intravenous ferric carboxymaltose (FCM) in the pediatric setting.
  
  
  METHODS
  All subjects who had received at least one dose of FCM intravenously in the observation period were included in this analysis with data collected for up to 3 months post last FCM dose.
  
  
  RESULTS
  In total, 72 children between 0 and 18 years with underlying gastrointestinal disorders had been treated for concomitant iron deficiency anemia. The majority of patients had Crohn's disease (40.3%) or ulcerative colitis (30.5%). The total number of FCM administrations was 147, the mean number per patient was 2.0 and the mean cumulative dose 821 mg iron (median single dose: 500 mg; max. 1000 mg). Post administration of FCM, correction of iron deficiency anemia was observed with improved mean hemoglobin levels from 9.5 g/dL at baseline to 11.9 g/dL within 5-12 weeks. Decreases in white cell count, platelets and C-reactive protein were observed post FCM, potentially suggesting reduced inflammation with iron repletion. Three subjects reported mild adverse drug reactions related to FCM; two of these were considered to be potentially related to long duration of administration and to high volume of saline solution for dilution. As such, the method of administration was amended to have a maximum infusion time of 60 minutes and dilution with less than or equal to 100 mL saline solution.
  
  
  CONCLUSIONS
  Overall FCM was well tolerated in this pediatric population and appeared to be effective in correcting iron deficiency anemia. We cannot exclude that the correction of iron deficiency anaemia is in some part due to the treatment of the underlying disease and not related to the iron supplementation only.
authors.affiliation: Department of Pediatrics, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstraβe 74, Dresden 01307, Germany. martin.laass@uniklinikum-dresden.de.
authors.forename: Martin W
authors.initials: MW
authors.lastname: Laass
authors.forename: Simon
authors.initials: S
authors.lastname: Straub
authors.forename: Suki
authors.initials: S
authors.lastname: Chainey
authors.forename: Garth
authors.initials: G
authors.lastname: Virgin
authors.forename: Timothy
authors.initials: T
authors.lastname: Cushway
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005290:Ferric Compounds / Q000009:adverse effects* / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D007262:Infusions, Intravenous; D008297:Male; D008320:Maltose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005290:Ferric Compounds; C522335:ferric carboxymaltose; D008320:Maltose