Iron Therapy

Maternal iron deficiency during pregnancy can lead to iron deficiency in infants, with potentially lifelong consequences, a new article indicates. The review explored iron status throughout the ‘first 1000 days’ from pregnancy through to two years of age, and emphasised the importance of identifying and treating iron deficiency, in addition to underlining remaining research gaps.

The optimal timing of intravenous iron therapy, in relationship to the type of erythropoiesis stimulating agent (ESA) used and the timing of ESA administration, has not been systematically studied. Since long-acting ESAs became available, it has not been established if there is an optimal window for intravenous iron use following ESA administration.

Iron therapy may be recommended during pregnancy for patients who have undergone liver or kidney transplant, new research indicates. The authors of the literature review recommend a haemoglobin level of 10–12 g/dL as a therapeutic goal in this patient group, to be achieved using erythropoietin-stimulating agents (ESAs) and iron therapy. They explain that management of anaemia may help to prevent preterm delivery.

Administering iron therapy to symptomatic, iron deficient patients with heart failure, over a one-year period, may result in sustainable improvement in functional capacity and symptoms, and may be associated with reduced hospitalisation. Authors of a new study state that, by targeting the iron deficiency in these patients overall quality of life (QoL) can be improved.

Cohen-Solal and colleagues have recently published an expert position paper from French cardiologists on the diagnosis and treatment of iron deficiency in patients with heart failure. This adds to the increasing literature, including clinical practice guidelines, and opinions expressed by cardiologists, on the possible benefits of correcting iron deficiency in heart failure, following on from Australian and European guidelines1,2.

Study results have revealed that treatment with intravenous ferric carboxymaltose is associated with a more frequent correction of post-operative anaemia than oral treatment with ferrous glycine sulphate.

Post-operative anaemia is common in patients undergoing major orthopaedic surgery such as total knee arthroplasty (TKA). The prolonged low haemoglobin levels following major surgery has been associated with increased mortality and morbidity.

Keeler and colleagues recently provided further evidence to support the use of intravenous iron to treat the anaemia associated with colorectal adenocarcinoma. This small open-label study was in the pre-operative setting, where previous studies have demonstrated that untreated anaemia can contribute to adverse postoperative outcomes.

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