Original Research
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction: Data comparing the clinical outcomes of iron sucrose versus ferric carboxymaltose is limited
Research Question or Hypothesis: is iron sucrose more effective than ferric carboxymaltose in the management of anemia?
Study Design: Retrospective observational cohort study.
Methods: This retrospective study, conducted at our quaternary care hospital between May 2015 and June 2019, included adults who received either iron sucrose or ferric carboxymaltose. For patients who received multiple iron courses, only the first encounter was analyzed. The primary outcome was the increase in hemoglobin levels. The Mann-Whitney U test compared outcomes versus baseline medians within each group, and the Wilcoxon signed-rank test compared the change in hemoglobin levels between the two groups.
Results: A total of 643 patients were analyzed, with 311 receiving iron sucrose (group 1) and 332 receiving ferric carboxymaltose (group 2). The median Charlson Comorbidity Index (CCI) was 1 (0-5) for group 1 and 4 (0-7) for group 2 (p<0.001). Both iron formulations significantly increased hemoglobin levels: group 1 from 93 (84-105) to 114 (99-127) g/L (p<0.001), and group 2 from 92 (81-103) to 103 (87-117) g/L (p<0.001). The change in hemoglobin was significantly greater with iron sucrose: 16.5 (5-29) compared to 6.5 (-1-21) for ferric carboxymaltose (p<0.001). Stepwise multivariate linear regression identified baseline hemoglobin [B=0.52 (0.4-0.6); p<0.001], ESA use [B=-7.4 (-11 to -3.8); p<0.001], total iron dose [B=0.01 (0.01-0.02); p<0.001], blood transfusion [B=-9.5 (-12 to -6.6); p<0.001], CCI [B=-0.6 (-1 to -0.12); p=0.013], and ferric carboxymaltose [B=-9.5 (-12 to -6.6); p<0.001] as the main predictors of hemoglobin level at the end of the study.
Conclusion: Multiple factors were shown to affect hemoglobin levels, which need to be considered when managing anemia, including the type of iron formulation used. Our findings need to be verified in larger prospective studies.
Presenting Author
Wasim Elnekidy PharmD, BCPS, BCACPCleveland Clinic Abu Dhabi
Authors
Emna Abidi PhD
Cleveland Clinic Abu Dhabi
Khaled Aldhanhani PharmD
Cleveland Clinic Abu Dhabi
Diaa Alrahmany BSc Pharm
3- Pharmaceutical Care Department, Directorate General of Medical Supplies, Ministry of Health, Muscat 3110, Oman
Islam Ghazi PharmD
Arnold and Marie Schwartz College of Pharmacy
Jihad Mallat MD
Cleveland Clinic Abu Dhabi
Lavinia Salama PharmD, BCACP, BC-ADM, CDCES
Albany College of Pharmacy and Health Sciences