Considerations for Practice

Study results have revealed that ferumoxytol may be a suitable treatment alternative to iron sucrose for patients with iron deficiency anaemia when oral iron is unsatisfactory or intolerable. The authors also suggest that ferumoxytol has the potential to increase treatment compliance in this patient population.

This year’s European Crohn’s and Colitis Organisation congress (ECCO) took place on the 20–22 February 2014 in Copenhagen, Denmark. The congress saw record attendance with a total of 5175 delegates from 78 countries. Sessions relating to iron deficiency in gastroenterology included details on emerging iron therapies for inflammatory bowel disease, biomarkers of iron absorption and iron deficiency, updates to ECCO guidelines and recent prevalence data for iron deficiency. Presented below are some of the highlights.

A new study demonstrates that there is a high prevalence of anaemia in patients with advanced chronic kidney disease, which increases in the later stages of the disease. The authors suggest that control of anaemia may be achieved with moderate doses of erythropoietin stimulating agent (ESA) and iron therapy, as per current guidelines.

Maternal iron deficiency, anaemia and common mental disorders (CMD) have adverse consequences on subsequent infant motor development, a new study in Vietnam indicates. The findings highlight the need to improve the quality of antenatal care for pregnant women in low- and middle-income countries.

Patients scheduled for major elective orthopaedic procedures frequently present with preoperative iron deficiency and anaemia1,2. Iron deficiency anaemia is the most common form of anaemia and preoperative anaemia has been linked to higher postoperative infection rate, poorer physical functioning and recovery, decreased quality of life, and increased length of hospital stay (LOS) and mortality1–5.

A recent study by Munoz and colleagues demonstrated that transfusion rates in patients with hip fracture were lower in those who received intravenous iron compared with those who received no iron therapy (32.4 vs 48.8%, respectively; n=2547). Postoperative nosocomial infection rates were lower in patients who received intravenous iron, as was thirty-day mortality and length of hospital stay1.

Intravenous iron may improve erythroid recovery in patients treated with DA after haematopoietic cell transplantation (HCT). Darbepoetin alfa (DA) helps to ensure full erythroid reconstitution after autologous HCT when started on day 28 post-transplant, a new study indicates.

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most widely used procedure for the surgical treatment of obesity in the USA.  Reduced iron absorption is an expected consequence of this surgical intervention due to exclusion of the duodenum and proximal jejunum resulting in reduced iron absorption, diminished exposure of food to gastric acidity and reduced dietary intake1.

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