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J A Nores
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November 2015: Journal of Minimally Invasive Gynecology
Ugo Salvadori, Marco Sandri, Cristina Melli, Francesca Polese, Maria Simeoni, Stefano Capelli, Ahmad Al-Khaffaf
BACKGROUND: The aim of this study was to evaluate the effectiveness of ferric carboxymaltose (FCM) in patients with iron deficiency anemia (IDA) secondary to gastrointestinal chronic blood loss (CBL), who received chronic transfusion support. STUDY DESIGN AND METHODS: We retrospectively evaluated 38 patients with IDA (hemoglobin [Hb] < 10 g/dL and ferritin < 12 ng/mL or transferrin saturation [TSAT] < 16%) refractory or intolerant to oral iron therapy that necessitated transfusion support in the previous 12 months...
September 7, 2016: Transfusion
Bruno M L Rocha, Luiz Menezes Falcão
Heart failure (HF) is an increasingly prevalent syndrome and a leading cause of both first hospitalization and readmissions. Strikingly, up to 25% of the patients are readmitted within 30 to 60-days, accounting for HF as the primary cause for readmission in the adult population. Given its poor prognosis, one could describe it as a "malignant condition". Acute decompensation is intrinsically related to increased right heart tele-diastolic pressures and often related to congestive symptoms. In-hospital strategies to adequately compensate and timely discharge patients are limited...
November 15, 2016: International Journal of Cardiology
Bettina Wurzinger, Peter König
Iron deficiency without anaemia is a widespread health problem that often remains undetected. In this context, neurological and psychopathological problems like fatigue and poor concentration are a major issue, but also in Restless-Legs-Syndrome (RLS) iron deficiency is a key element.The exact pathogenesis is often unknown, however, it is known that iron is involved in several very important metabolic processes in the human body. In particular when it comes to fatigue and RLS, it's assumed that reduced activity of tyrosine hydroxylase - a central iron-dependent element of dopamine synthesis - can lead to deficiencies...
October 2016: Wiener Medizinische Wochenschrift
Sara Valério de Azevedo, Catarina Maltez, Ana Isabel Lopes
BACKGROUND AND AIMS: Increasing evidence in adults demonstrates efficacy and safety of IV iron in inflammatory Bowel disease (IBD) associated iron deficiency anemia; however, evidence in pediatric patients is yet scarce and no previous study has included a long follow-up. This study aimed to evaluate safety and efficacy of IV iron (primary end point), and the need of re-treatment (secondary end point), in this setting. METHODS: Prospective recruitment (40 months); PCDAI determined before and after treatment; anemia defined according to WHO criteria; IV iron treatment included iron sucrose and ferric carboxymaltose...
August 31, 2016: Scandinavian Journal of Gastroenterology
Alhossain A Khalafallah, Carl Yan, Raghad Al-Badri, Ella Robinson, Brooke E Kirkby, Emily Ingram, Zara Gray, Vinod Khelgi, Iain K Robertson, Brian P Kirkby
BACKGROUND: Despite increasing efforts in perioperative management, postoperative iron deficiency anaemia persists, and few data are available about the management of this condition. In this study, we aimed to determine whether giving postoperative intravenous iron (in the form of ferric carboxymaltose) improved iron stores, haemoglobin concentrations, and outcomes following surgery. METHODS: We did a prospective, open-label, randomised, controlled study of patients at two centres (a general hospital and a private health-care centre) in Tasmania, Australia, undergoing elective surgery with functional iron deficiency anaemia (haemoglobin 70-120 g/L and ferritin ≤100 μg/L or iron saturation ≤20%), measured at day 1 postoperatively...
September 2016: Lancet Haematology
Saba Haddad, Yong Wang, Bruno Galy, Mortimer Korf-Klingebiel, Valentin Hirsch, Abdul M Baru, Fatemeh Rostami, Marc R Reboll, Jörg Heineke, Ulrich Flögel, Stephanie Groos, André Renner, Karl Toischer, Fabian Zimmermann, Stefan Engeli, Jens Jordan, Johann Bauersachs, Matthias W Hentze, Kai C Wollert, Tibor Kempf
AIMS: Iron deficiency (ID) is associated with adverse outcomes in heart failure (HF) but the underlying mechanisms are incompletely understood. Intracellular iron availability is secured by two mRNA-binding iron-regulatory proteins (IRPs), IRP1 and IRP2. We generated mice with a cardiomyocyte-targeted deletion of Irp1 and Irp2 to explore the functional implications of ID in the heart independent of systemic ID and anaemia. METHODS AND RESULTS: Iron content in cardiomyocytes was reduced in Irp-targeted mice...
August 21, 2016: European Heart Journal
Susann Neiser, Taija S Koskenkorva, Katrin Schwarz, Maria Wilhelm, Susanna Burckhardt
Intravenous iron preparations are typically classified as non-dextran-based or dextran/dextran-based complexes. The carbohydrate shell for each of these preparations is unique and is key in determining the various physicochemical properties, the metabolic pathway, and the immunogenicity of the iron-carbohydrate complex. As intravenous dextran can cause severe, antibody-mediated dextran-induced anaphylactic reactions (DIAR), the purpose of this study was to explore the potential of various intravenous iron preparations, non-dextran-based or dextran/dextran-based, to induce these reactions...
2016: International Journal of Molecular Sciences
Monica Varcher, Sofia Zisimopoulou, Olivia Braillard, Bernard Favrat, Noëlle Junod Perron
BACKGROUND: Iron deficiency is a common problem in primary care and is usually treated with oral iron substitution. With the recent simplification of intravenous (IV) iron administration (ferric carboxymaltose) and its approval in many countries for iron deficiency, physicians may be inclined to overutilize it as a first-line substitution. OBJECTIVE: The aim of this study was to evaluate iron deficiency management and substitution practices in an academic primary care division 5 years after ferric carboxymaltose was approved for treatment of iron deficiency in Switzerland...
2016: International Journal of General Medicine
Nicole K Bart, M Kate Curtis, Hung-Yuan Cheng, Sara L Hungerford, Ross McLaren, Nayia Petousi, Keith L Dorrington, Peter A Robbins
Sustained hypoxia over several hours induces a progressive rise in pulmonary artery systolic pressure (PASP). Administration of intravenous iron immediately prior to the hypoxia exposure abrogates this effect, suggesting that manipulation of iron stores may modify hypoxia-induced pulmonary hypertension. Iron (ferric carboxymaltose) administered intravenously has a plasma half-life of 7-12 h. Thus any therapeutic use of intravenous iron would require its effect on PASP to persist long after the iron-sugar complex has been cleared from the blood...
August 1, 2016: Journal of Applied Physiology
Niklas Lofruthe, Inka Gallitz, Lisa Traeger, Nicole Bäumer, Isabell Schulze, Tanja Kuhlmann, Carsten Müller-Tidow, Andrea U Steinbicker
Intravenous iron supplementation is an effective therapy in iron deficiency anemia (IDA), but controversial in anemia of inflammation (AI). Unbound iron can be used by bacteria and viruses for their replication and enhance the inflammatory response. Nowadays available high molecular weight iron complexes for intravenous iron substitution, such as ferric carboxymaltose, might be useful in AI, as these pharmaceuticals deliver low doses of free iron over a prolonged period of time. We tested the effects of intravenous iron carboxymaltose in murine AI: Wild-type mice were exposed to the heat-killed Brucella abortus (BA) model and treated with or without high molecular weight intravenous iron...
2016: PloS One
Athina Drakou, Alexandra Margeli, Stamatia Theodorakopoulou, Ioannis Agrogiannis, Christos Poziopoulos, Ioannis Papassotiriou, Demetrios V Vlahakos
BACKGROUND: No reliable biomarker exists to predict responsiveness to intravenous (IV) iron (Fe) in iron deficient patients with CKD. We aimed to investigate the clinical value of bioactive Hepcidin-25 and soluble Transferrin Receptor (sTfR) levels in predialysis patients. PATIENTS AND METHODS: In this prospective study 78 stable stage III-IV CKD predialysis patients with (responders) (40 patients) and without (non-responders) (38 patients) adequate erythropoiesis after IV administration of ferric-carboxymaltose (FCM)...
July 2016: Blood Cells, Molecules & Diseases
Christian Breymann, Nils Milman, Anna Mezzacasa, Roubert Bernard, Joachim Dudenhausen
OBJECTIVE: To compare the efficacy and safety of intravenous ferric carboxymaltose (FCM) with first-line oral ferrous sulfate (FS) in pregnant women with iron deficiency anemia (IDA). MATERIALS AND METHODS: Pregnant women (n=252; gestational weeks 16-33) with IDA were randomized 1:1 to FCM (1000-1500 mg iron) or FS (200 mg iron/day) for 12 weeks. The primary objective was to compare efficacy; secondary objectives included safety and quality of life. RESULTS: Hemoglobin (Hb) levels improved at comparable rates across both treatments; however, significantly more women achieved anemia correction with FCM vs...
June 8, 2016: Journal of Perinatal Medicine
Carlo A Gaillard, Andreas H Bock, Fernando Carrera, Kai-Uwe Eckardt, David B Van Wyck, Sukhvinder S Bansal, Maureen Cronin, Yvonne Meier, Sylvain Larroque, Simon D Roger, Iain C Macdougall
Hepcidin is the key regulator of iron homeostasis but data are limited regarding its temporal response to iron therapy, and response to intravenous versus oral iron. In the 56-week, open-label, multicenter, prospective, randomized FIND-CKD study, 626 anemic patients with non-dialysis dependent chronic kidney disease (ND-CKD) and iron deficiency not receiving an erythropoiesis stimulating agent were randomized (1:1:2) to intravenous ferric carboxymaltose (FCM), targeting higher (400-600μg/L) or lower (100-200μg/L) ferritin, or to oral iron...
2016: PloS One
M J Sangrós Sahún, E Goñi Gironés, A Camarero Salazar, C Estébanez Estébanez, M E Lozano Martínez
The development of hypophosphataemic osteomalacia has been linked with several treatments, mainly antiretroviral and intravenous iron administration. The frequency of the hypophosphataemia requires monitoring the phosphate after the administration of iron carboxymaltose. We describe a case of a woman with no calcium-phosphorous metabolism disorder, to whom this treatment was prescribed for anaemia due to menorrhagia and intolerance to oral iron. She started with oligoarticular pain, which was spreading with a significant functional loss...
May 27, 2016: Revista Española de Medicina Nuclear e Imagen Molecular
Máximo Bernabeu-Wittel, Manuel Romero, Manuel Ollero-Baturone, Reyes Aparicio, José Murcia-Zaragoza, Manuel Rincón-Gómez, Rafael Monte-Secades, María Melero-Bascones, Clara M Rosso, Alberto Ruiz-Cantero
BACKGROUND: The increasing incidence of osteoporotic hip fracture (HF) has raised the requirements of red blood cell (RBC) transfusions, whereas this scarce resource may cause morbidity and mortality. STUDY DESIGN AND METHODS: This study was a multicenter, randomized, double-blind, clinical trial that aimed to assess efficacy of ferric carboxymaltose (FCM) with or without erythropoietin (EPO) in reducing RBC transfusion in the perioperative period of HF. Participants (patients > 65 years admitted with HF and hemoglobin [Hb] levels of 90-120 g/L) were randomly assigned to receive a preoperative single dose of 1 g of FCM (short intravenous [IV] infusion over 15 min), plus 40,000 IU of subcutaneous EPO (EPOFE arm); versus 1 g of IV FCM plus subcutaneous placebo (FE arm); and versus IV and subcutaneous placebo (placebo arm)...
September 2016: Transfusion
Lisa H Fell, Sarah Seiler-Mußler, Alexander B Sellier, Björn Rotter, Peter Winter, Martina Sester, Danilo Fliser, Gunnar H Heine, Adam M Zawada
BACKGROUND: Treatment of iron deficiency with intravenous (i.v.) iron is a first-line strategy to improve anaemia of chronic kidney disease. Previous in vitro experiments demonstrated that different i.v. iron preparations inhibit differentiation of haematopoietic stem cells to monocytes, but their effect on monocyte differentiation to macrophages and mature dendritic cells (mDCs) has not been assessed. We investigated substance-specific effects of iron sucrose (IS), sodium ferric gluconate (SFG), ferric carboxymaltose (FCM) and iron isomaltoside 1000 (IIM) on monocytic differentiation to M1/M2 macrophages and mDCs...
March 24, 2016: Nephrology, Dialysis, Transplantation
Santiago García-López, Judith Millastre Bocos, Javier P Gisbert, Eduardo Bajador, María Chaparro, Carlos Castaño, José A García-Erce, Fernando Gomollón
BACKGROUND: Anaemia and iron deficiency are very common in inflammatory bowel disease. Clinical trials have shown intravenous iron to be effective and well tolerated. However, published experience in clinical practice with specific evaluation of the effect on quality of life is limited. MATERIAL AND METHODS: We carried out a prospective, multicentre, observational study on the effects of ferric carboxymaltose in the treatment of iron deficiency anaemia in inflammatory bowel disease...
May 2016: Blood Transfusion, Trasfusione del Sangue
Trond J Cooper, Stefan D Anker, Josep Comin-Colet, Gerasimos Filippatos, Mitja Lainscak, Thomas F Lüscher, Claudio Mori, Patrick Johnson, Piotr Ponikowski, Kenneth Dickstein
Clinical status in heart failure is conventionally assessed by the physician's evaluation, patients' own perception of their symptoms, quality of life (QoL) tools, and a measure of functional capacity. These aspects can be measured with tools such as the New York Heart Association functional class, QoL tools such as the EuropeanQoL-5 dimension, the Kansas City Cardiomyopathy Questionnaire, patient global assessment (PGA), and by 6-minute walk test (6MWT), respectively. The ferric carboxymaltose in patients with heart failure and iron deficiency (FAIR-HF) trial demonstrated that treatment with intravenous ferric carboxymaltose in iron-deficient patients with symptomatic heart failure with reduced left ventricular function, significantly improved all 5 outcome measures...
May 1, 2016: American Journal of Cardiology
Ajay Gupta, Raymond D Pratt, Alvin L Crumbliss
The observed biological differences in safety and efficacy of intravenous (IV) iron formulations are attributable to physicochemical differences. In addition to differences in carbohydrate shell, polarographic signatures due to ferric iron [Fe(III)] and ferrous iron [Fe(II)] differ among IV iron formulations. Intravenous iron contains Fe(II) and releases labile iron in the circulation. Fe(II) generates toxic free radicals and reactive oxygen species and binds to bacterial siderophores and other in vivo sequestering agents...
June 2016: Biometals: An International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine
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