Introduction Iron deficiency is common in the inflammatory bowel disease population (36%–90%1) and is often poorly managed. Guidelines on the management of iron deficiency anaemia recommend that parenteral iron should be used if oral iron supplementation is either ineffective or not tolerated.1 Iron Sucrose (IS, Venofer®) infusions take on average 85 min to be administered and require between 5 and 13 infusions for a therapeutic dose of iron to be given. Ferric Carboxymaltose (FC, Ferinject®) is a total dose infusion parenteral iron preparation. It requires 1–2 infusions for therapeutic dose delivery and allows shorter administration times. We audited the outcomes of switching from IS to FC in terms of therapeutic efficacy and patient experience.
Methods Current practice with IS was prospectively audited over a 6-week period. All admissions for parenteral iron to the Managed Care Unit (MCU) were included. Nursing staff completed a questionnaire including patient demographics, indication and record the patient journey. Patients completed a satisfaction survey. FC was introduced in early December 2011 and data collected for a further 6-week period. FC was dosed according to the summary of product characteristics, updated 25 October 2011.
Results Data are presented as median (range) unless otherwise stated. All patients in the FC group and 45% in the IS group were cannulated at the first attempt. No patients in the FC group and 20% in the IS group reported severe pain on cannulation. All patients in the FC group and 83% in the IS group received their full course. It took a median -days (range) of 49 (30–113) for the IS patients and 9 (8–10) for the FC patients to complete their treatment course. Two patients in the FC group who had previously had IS commented on the advantage of fewer infusions. In both groups over 70% of patients rated their experience as good or very good.
Conclusion This real life data shows clear advantages of using a TDI parenteral iron preparation. A reduction in the number of admissions and time spent in the MCU is demonstrated with more patients receiving the recommended dose in a shorter time. Efficiency can be improved by advanced prescribing and our data may show gaps in the knowledge of prescribers. Patient satisfaction remained high with FC.
Competing interests J Swabe: None Declared, C Wijayasekara: None declared, J Allen: None declared, F Cummings speaker bureau with: Vifor Pharmaceuticals.
Reference 1. Gomollón F, Gisbert JP. Anemia and inflammatory bowel diseases. World J Gastroenterol. 2009;15:4659–65.
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