title: Comparative efficacy and safety of intravenous ferric carboxymaltose (Ferinject) and iron(III) hydroxide dextran (Cosmofer) in pregnancy.
abstract: BACKGROUND
  Iron-deficiency anaemia is common in pregnancy, with well-described maternal morbidities. When oral iron therapy has failed, intravenous (IV) preparations are considered. Ferric carboxymaltose (ferinject) is a new IV preparation which can be given quickly. There are no published data on Ferinject use in pregnancy. This study analyses historical data from women given Cosmofer, compared with those given Ferinject in pregnancy, to assess comparative efficacy and safety.
  
  
  METHODS
  Pregnant women treated with Cosmofer and Ferinject, were identified from pharmacy records. Records for all cases were reviewed and those which fulfilled inclusion criteria selected. The inclusion criteria included: symptomatic iron-deficient anaemia unresponsive to oral iron; age ≥18; second to third trimester; full blood count taken at least once at two, four and/or six weeks post-infusion. Data were collected on the pre-treatment Hb, ferritin, and same data collected at two, four and six weeks after the infusion. Side-effects or adverse reactions were noted for both the Cosmofer and Ferinject patients.
  
  
  RESULTS
  Results were obtained for 92 women (44 received Ferinject and 48 Cosmofer). Pre-infusion Hb and ferritin levels were comparable in the two groups. At two weeks, the mean Hb rise in the Ferinject group was 1.73 g/dL and 1.34 g/dL in the Cosmofer group. At four weeks, the total rise in Hb was 2.57 g/dL Ferinject, 2.34 g/dL Cosmofer. At six weeks the rise was 3.01 g/dL and 3.2 g/dL respectively. No serious adverse events were reported in either group.
  
  
  CONCLUSIONS
  Both preparations appear effective and safe, with low risk of serious adverse effects and side-effects.
authors: Haematology Department, Lincoln County Hospital, Lincoln LN2 5QY, UK; Haematology Department, Nottingham University Hospitals, City Campus.
authors: B
authors: B
authors: Myers
authors: Aberdeen University, King's College , Aberdeen AB24 3FX , UK.
authors: O
authors: O
authors: Myers
authors: Obstetric Department, Nottingham City Hospitals , City Campus, Hucknall Rd, Nottingham NG5 1PB , UK.
authors: J
authors: J
authors: Moore
keywords: haematology; maternal–fetal medicine