Treatment

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.

A comprehensive literature review has described the importance of treating iron deficiency in patients with heart failure. Authors state that iron deficiency is common, with a prevalence of up to 50%, but is often overlooked in this population. They describe a favourable effect of intravenous iron in this population, and provide an overview of future clinical trials that will explore the benefits of iron deficiency correction on various heart failure parameters.

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.

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.

Iron sucrose is a frequently used intravenous iron compound for the treatment of iron deficiency and iron deficiency anemia in a broad range of therapeutic areas, including in patients with conditions such as chronic kidney disease, inflammatory bowel disease, pregnancy (second and third trimester), postpartum period, heavy menstrual bleeding and cancer.

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.

A retrospective study has revealed that iron therapy is associated with a reduction in platelet count in patients with non-dialysis chronic kidney disease (ND-CKD) independent of erythropoiesis-stimulating agent (ESA) use. Iron therapy may therefore reduce the risk of relative thrombocytosis in this patient population.

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