The safety of available treatment options for iron-deficiency anemia. Issue 2 (1st February 2018)

• Record Type: Journal Article
• Authors: Muñoz, Manuel; Gómez-Ramírez, Susana; Bhandari, Sunil
• Is Part Of: Expert opinion on drug safety. Volume 17:Issue 2(2018)
• Page Start: 149
• Page End: 159
• Publication Date: 2018-02-01
• Subjects: Iron deficiency -- anaemia -- oral iron -- intravenous iron -- safety; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2018.1400009
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Introduction : Iron deficiency (ID), with or without anemia, is highly prevalent worldwide and has clinical consequences. The prevention and treatment of ID is a major public health goal. Accurate diagnosis, selection of the appropriate iron replacement therapy and addressing the underlying cause, remain as the main challenges in ID management. Areas covered : This review aims to provide a narrative review of current available evidence on iron supplementation options regularly used to treat ID, including oral and intravenous (IV) iron formulations, with emphasis on safety issues. Analyzed safety concerns include gastrointestinal side effects (oral iron) and risks of hypotension, anaphylaxis, infection, hypophosphatemia, oxidative stress and mortality (IV iron). Expert opinion : Low-to-moderate doses of oral iron supplementation remains as first line therapy for uncomplicated ID, but it has been scarcely discussed in the setting of inflammation. Confirmatory studies on the efficacy of newer oral iron formulations in this setting are needed. Compared with oral iron, short-term IV iron administration is more efficacious in ID correction, without significant safety concerns. However, long-term safety of IV iron maintenance therapy, head to head comparisons of IV iron preparations, pharmacological modulation of hepcidin and HIF, and extra-erythropoietic effects of iron are among the important areas of research.