Authors (including presenting author) :
Kuong JCH(1), Li CY(1), So WY(2)
Affiliation :
(1)Pharmacy Department, United Christian Hospital, (2)School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong
Introduction :
Introduction:
Ferric carboxymaltose (FCM) and iron isomaltoside (IIM) are two newer intravenous (IV) iron formulations that have been increasingly used because of their favorable safety profile and their ability to rapidly correct iron deficiency anemia. Notably, clinically significant hypophosphatemia has emerged as an important adverse effect of concern, especially with FCM, as reported by overseas studies.
Objectives :
Objectives:
This study aimed to conduct a drug utilization evaluation comparing the safety and efficacy between FCM and IIM in local patients with iron deficiency anemia, with a focus on assessing the incidence of hypophosphatemia following IV iron therapy.
Methodology :
Methodology:
This single-center, retrospective cohort study was conducted at United Christian Hospital in Hong Kong. Patients who had received FCM or IIM for the treatment of iron deficiency anemia within the study period between September 2021 and September 2023 were included. Patients with reduced kidney function were excluded. The primary outcome was the incidence of hypophosphatemia, defined as serum phosphate level <0.81 mmol/L within 90 days after IV iron therapy. Secondary outcomes included changes in phosphate and hemoglobin level, incidence of severe hypophosphatemia, subsequent phosphate treatments, and incidence of hypersensitivity reaction. The results were analyzed by the Pearson’s Chi-square test and binary logistic regression model. Statistical analyses were performed using SPSS Statistics 22.
Result & Outcome :
Results:
A total of 80 patients were included in the final analysis. The incidence of hypophosphatemia within 90 days post-treatment was significantly greater among patients treated with FCM than with IIM [14 (40%) vs. 3 (6.7%), P < 0.001]. The choice of IV iron formulation and baseline serum phosphate level were independent factors predisposing patients to hypophosphatemia. Both groups showed a drop in serum phosphate levels following treatment. Significant differences in serum phosphate levels between the FCM and IIM groups were shown on days 0 to 30 post-treatment (0.758 ± 0.286 mmol/L vs. 1.102 ± 0.194 mmol/L, P < 0.001). Both groups demonstrated a significant hemoglobin response as early as within 30 days after treatment.
Conclusion:
Local data demonstrated hypophosphatemia was more likely to occur following treatment with FCM compared to IIM. The importance of monitoring serum phosphate levels after FCM treatment should therefore be highlighted in local practice.
