Journal of Blood Medicine (Mar 2022)
Relationship Between Initial Parenteral Iron Therapy Dosing and Treatment Effectiveness: A Real-World Retrospective Analysis
Abstract
Chris LaVallee,1 Isha Bansal,2 Shilpa Kamdar,2 Winghan Jacqueline Kwong,3 Ralph V Boccia4 1Health Outcomes Research, Decision Resources Group, Burlington, MA, USA; 2Analytics, Decision Resources Group, Burlington, MA, USA; 3Health Economics & Outcomes Research, Daiichi Sankyo Inc., Basking Ridge, NJ, USA; 4Center for Cancer and Blood Disorders, P.C, Bethesda, MD, USACorrespondence: Winghan Jacqueline Kwong, Daiichi Sankyo, Inc., 211 Mt Airy Road, Basking Ridge, NJ, 07920, USA, Tel +1 908 992 7063, Email [email protected]: Replacement iron is the main treatment for iron deficiency, but the relationship between initial intravenous (IV) dose and need for additional treatment is unclear. This study explored patterns of IV iron dosing in US clinical practice.Methods: Patient records were obtained for adults who received IV iron for anemia between 2015 and 2017. Patients were classified into four groups: those who received 1000 mg within 3 weeks of their first dose. The proportion of patients requiring additional IV iron after 30 days of the initial dose was evaluated.Results: Data were obtained for 2959 patients receiving iron sucrose (44.2%), ferric carboxymaltose injection (FCM) (25.8%), and ferumoxytol (FM) (14.3%). Overall, 567 patients (19%) received ≥ 1500 mg of IV iron and 942 (32%) received > 1000 mg of IV iron within the first 21 days. Mean (SD) baseline iron deficit was 1001 mg (312). Patients who received ≥ 1500 mg had a 32% lower probability of receiving additional IV iron than those who received 1000 mg had a 41% lower probability of receiving additional IV iron than those who received ≤ 1000 mg (adjusted HR: 0.59 [95% CI; 0.52, 0.67]) and had significantly fewer outpatient visits for all causes (p 1000 mg IV iron.Conclusion: Higher doses of IV iron within 3 weeks of first dose may reduce further IV iron treatment needs and outpatient visits.Keywords: anemia, ferric carboxymaltose injection, ferumoxytol, iron sucrose