Eficacia y seguridad de la infusión total de hierro en el tratamiento de la anemia ferropriva en adultos no gestantes / Safety and efficacy of total dose intravenous iron infusion in the treatment of iron-deficiency anemia in adult non-pregnant patients

RESUMO

INTRODUCTION: Iron deficiency anemia (IDA) has a prevalence of 20-24.5 in Mexico, which is similar to other developing countries. Although the treatment of choice is oral iron therapy, several factors limit its efficacy. Intravenous administration of iron-dextran is an effective method that has been evaluated in pregnant women, children and renal patients and there are some studies demonstrating its safety in these groups. We carried out a prospective, longitudinal, uncontrolled clinical trial to evaluate the safety and efficacy of total-dose intravenous iron infusion in the treatment of IDA in adult, non-pregnant patients. MATERIALS AND METHODS: Forty-seven patients (8 male, 39 female) with anemia and iron deficiency were included in the study. Iron deficit was calculated and a total dose iron infusion was administered intravenously diluted in normal saline over 4 hours. CBC were obtained at 2-week intervals until week 8 post-infusion. The percentage of hematocrit correction was calculated at week 8 post-infusion. RESULTS: Baseline hemoglobin values were 78 +/- 17.2 for the whole group, 85 +/- 20.4 for men and 78 +/- 16.7 g/L for women. At week 8 values were 134 +/- 10.7, 138 +/- 9.8 and 134 +/- 10.8 g/L for the whole group, men and women, respectively. Baseline hematocrit values were 0.27 +/- 0.05 for the whole group, 0.29 +/- 0.06 for men and 0.27 +/- 0.05 for women. At week 8 values were 0.42 +/- 0.03, 0.43 +/- 0.03 and 0.42 +/- 0.03 for the whole group, men and women, respectively. The percentage of hematocrit correction was 51.5 +/- 28.6 at week 2 and 80.3 +/- 21.3 at week 8. Thirty-two percent of patients developed adverse reactions, all but one being mild. CONCLUSIONS: We confirmed that total-dose iron infusion is a safe and effective method to treat IDA that may be used in patients with intolerance to oral iron or in patients with failure to other iron schedules, as well as initial therapy in selected cases. Besides it provides a swift correction of hematocrit allowing, in some cases, to perform elective surgery without the need of blood transfusion.