Ferric carboxymaltose treatment for iron deficiency anemia in children with inflammatory bowel disease: Efficacy and risk of hypophosphatemia. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Cococcioni, Lucia; Pensabene, Licia; El-Khouly, Sara; Chadokufa, Sibongile; McCartney, Sara; Saliakellis, Efstratios; Kiparissi, Fevronia; Borrelli, Osvaldo
• Is Part Of: Digestive and liver disease. Volume 53:Issue 7(2021)
• Page Start: 830
• Page End: 834
• Publication Date: 2021-07
• Subjects: Anemia -- Paediatric IBD -- Ferric carboxymaltose -- Hypophosphatemia; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.02.017
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: Although intravenous ferric carboxymaltose (FCM) is effective in treating iron deficiency anemia (IDA) in paediatric inflammatory bowel disease (pIBD), no data are available on its post-infusion related risks. Aims: We assessed the efficacy of FCM and the rate of post-infusion hypophosphatemia in a large cohort of children with IBD and IDA. Methods: All children with IBD with IDA treated with FCM over 5-year period were reviewed. Disease activity, biohumoral assessment and treatments were evaluated at baseline, 4–6 and 12 weeks after each infusion. Results: 128 patients [median age at first infusion: 13 years] were identified, 81 (63.3%) were <14 years, 10 (7.8%) <6 years. Eighty-three children (64.8%) received one infusion, whilst 45 (35.2%) repeated infusions. A significant increase in Hb ( p <0.001), iron ( p <0.001) and ferritin ( p <0.001) was observed 4–6 and 12 weeks post-infusion. Hb gain was unrelated to disease severity. Low baseline iron was the main predicting factor for repeated infusions ( p <0.05). Three patients reported infusion reactions, none <6 years. Twenty-five children had low post-infusion serum phosphate (11 were <14 years, 3 <6 years). Two children developed severe hypophosphatemia. Conclusions: FCM administration is effective for IDA management in pIBD, including children <6 years. Due to the high prevalence of post-infusion hypophosphatemia, serum phosphate monitoring should be mandatory.