WASHINGTON—Ferric citrate, a novel oral medication for treating iron deficiency anemia in patients with chronic kidney disease (CKD), improves iron levels to a greater extent than ferrous sulfate, according to study data presented at the American Society of Nephrology’s Kidney Week 2019 conference.
Rebecca L. Womack and colleagues at the University of Alabama in Birmingham randomly assigned 60 patients with CKD stages 3b to 4 and iron deficiency (transferrin saturation [TSAT] less than 30% and ferritin levels below 300 ng/mL) to receive either ferric citrate or ferrous sulfate for 12 weeks. Each group had 30 patients. The primary outcomes were change in TSAT and ferritin. A total of 25 patients in the ferric citrate arm and 26 in the ferrous sulfate arm completed all study visits.
The investigators observed no significant changes in TSAT or phosphate in either study arm. Serum ferritin and hemoglobin levels, however, increased significantly in the ferric citrate arm but not in the ferrous sulfate arm. In addition, intact fibroblast growth factor 23 (FGF23) decreased by a significant 19% in the ferric citrate arm and a nonsignificant 3% in the ferrous sulfate arm. C-terminal FGF23 decreased by 15% in the ferric citrate arm and 14% in the ferrous sulfate arm. Both groups experienced similar adverse events.
Womack RL, Panwar B, Gutierrez OM. Effect of ferric citrate vs. ferrous sulfate on iron, hemoglobin, and mineral metabolism in CKD. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held November 5 to 10 in Washington, DC. Abstract TH-OR029.