title: Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations.
abstract: Objective. To provide clinicians with evidence-based guidance for iron therapy dosing in patients with iron deficiency anemia (IDA), we conducted a study examining the benefits of a higher cumulative dose of intravenous (IV) iron than what is typically administered. Methods. We first individually analyzed 5 clinical studies, averaging the total iron deficit across all patients utilizing a modified Ganzoni formula; we then similarly analyzed 2 larger clinical studies. For the second of the larger studies (Study 7), we also compared the efficacy and retreatment requirements of a cumulative dose of 1500 mg ferric carboxymaltose (FCM) to 1000 mg iron sucrose (IS). Results. The average iron deficit was calculated to be 1531 mg for patients in Studies 1-5 and 1392 mg for patients in Studies 6-7. The percentage of patients who were retreated with IV iron between Days 56 and 90 was significantly (p < 0.001) lower (5.6%) in the 1500 mg group, compared to the 1000 mg group (11.1%). Conclusions. Our data suggests that a total cumulative dose of 1000 mg of IV iron may be insufficient for iron repletion in a majority of patients with IDA and a dose of 1500 mg is closer to the actual iron deficit in these patients.
authors.affiliation: Luitpold Pharmaceuticals, Inc., Norristown, PA 19403, USA.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Koch
authors.affiliation: St. John's University, Jamaica, NY 11439, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Myers
authors.affiliation: Department of Pathology and Medicine (Hematology), Stanford, CA 94305, USA.
authors.forename: Lawrence Tim
authors.initials: LT
authors.lastname: Goodnough