IV Iron Drugs Not Equal in Hemoglobin Response

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NATIONAL HARBOR, Md.—In a recently completed clinical trial, treatment with ferumoxytol resulted in a greater hemoglobin (Hb) response than iron sucrose in hemodialysis (HD) patients with anemia and non-dialysis patients with severe anemia, researchers reported at the National Kidney Foundation 2012 Spring Clinical Meetings.

William Strauss, MD, of AMAG Pharmaceuticals in Lexington, Mass., and colleagues studied 162 patients who participated in the FIRST trial, which compared the two intravenous iron preparations. Ferumoxytol was administered as two injections of 510 mg five days apart; iron sucrose was administered as 10 100 mg injections within three weeks to HD patients or as five 200 mg injections within about two weeks to non-dialysis patients.

Of the 162 patients, 70 were on HD (34 who received ferumoxytol and 36 who received iron sucrose). The mean Hb level from baseline to day 35 rose by 1.02 g/dL in the ferumoxytol recipients versus 0.54 g/dL in the iron sucrose group. Among non-dialysis patients with a baseline Hb of 7-9 g/dL (10 who received ferumoxytol and 11 who received iron sucrose), the mean Hb level increased by 1.39 g/dL among ferumoxytol-treated patients compared with 0.63 in the iron sucrose recipients.

In addition, the percentage of HD patients who achieved 1 g/dL or greater rise in Hb from baseline to day 35 was 56% among ferumoxytol recipients versus 39% among iron sucrose patients. The percentages were 70% and 46% for the patients with baseline Hb levels of 7-9 g/dL.

The differences in hematopoietic response may be due to the delivery of more iron earlier with the ferumoxytol dosing regimen, the researchers noted.
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