Newer formulations of intravenous iron: a review of their chemistry and key safety aspects - hypersensitivity, hypophosphatemia, and cardiovascular safety

被引:59
作者
Blumenstein, Irina [1 ]
Shanbhag, Satish [2 ,3 ]
Langguth, Peter [4 ]
Kalra, Philip A. [5 ,6 ]
Zoller, Heinz [7 ]
Lim, Wendy [8 ]
机构
[1] Univ Clin Frankfurt, Dept Gastroenterol Hepatol & Clin Nutr, Med Dept 1, Frankfurt, Germany
[2] Canc Specialists North Florida, Dept Hematol Med Oncol, Fleming Isl, FL USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, Div Hematol, Baltimore, MA USA
[4] Johannes Gutenberg Univ Mainz, Dept Biopharmaceut & Pharmaceut Technol, Inst Pharm & Biochem, Mainz, Germany
[5] Salford Royal NHS Fdn Trust, Dept Renal Med, Salford, Lancs, England
[6] Univ Manchester, Fac Biol Med & Hlth, Manchester, Lancs, England
[7] Med Univ Innsbruck, Dept Med Gastroenterol Hepatol & Endocrinol 1, Innsbruck, Austria
[8] McMaster Univ, St Josephs Healthcare Hamilton, Div Hematol & Thromboembolism, Dept Med, Hamilton, ON, Canada
关键词
Anemia; ferric carboxymaltose; ferric derisomaltose; ferumoxytol; heart failure; iron deficiency; iron isomaltoside; hypersensitivity; hypophosphatemia; intravenous iron; CHRONIC HEART-FAILURE; FERRIC CARBOXYMALTOSE; DEFICIENCY ANEMIA; PHYSICOCHEMICAL PROPERTIES; ISOMALTOSIDE; 1000; PHOSPHATE; HOMEOSTASIS; MANAGEMENT; PRODUCTS; DRUGS;
D O I
10.1080/14740338.2021.1912010
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: The newest intravenous (IV) iron products show an improved safety profile over predecessors, allowing for the rapid administration of relatively high doses. Ferric derisomaltose (FDI; also known as iron isomaltoside), ferric carboxymaltose (FCM), and ferumoxytol (FER), are successful treatments for iron deficiency (Europe; FDI and FCM) and iron deficiency anemia (US; FDI, FCM, and FER). Areas covered: This review focusses on the chemistry and structure of FDI, FCM, and FER, and on three key aspects of IV iron safety: (1) hypersensitivity; (2) hypophosphatemia and sequelae; (3) cardiovascular safety. Expert opinion: Although the safety of modern IV iron has improved, immediate infusion reactions and the development of hypophosphatemia must be appreciated and recognized by those who prescribe and administer IV iron. Immediate infusion reactions can occur with any IV iron and are usually mild; severe reactions - particularly anaphylaxis - are extremely rare. The recognition and appropriate management of infusion reactions is an important consideration to the successful administration of IV iron. Severe, persistent, hypophosphatemia is a specific side effect of FCM. No cardiovascular safety signal has been identified for IV iron. Ongoing trials in heart failure will provide additional long-term efficacy and safety data.
引用
收藏
页码:757 / 769
页数:13
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