Premium
Safety and efficacy of parenteral iron in children with inflammatory bowel disease
Author(s) -
Papadopoulos Michael,
Patel Deepa,
KorologouLinden Roxanna,
Goto Eunice,
Soondrum Krishna,
Fell John M. E.,
Epstein Jenny
Publication year - 2018
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13493
Subject(s) - medicine , iron sucrose , tolerability , transferrin saturation , inflammatory bowel disease , iron deficiency , gastroenterology , adverse effect , rash , diarrhea , pediatrics , anemia , disease , intravenous iron
Aims Iron deficiency anaemia frequently complicates inflammatory bowel disease (IBD) in children and adults. Oral iron may exacerbate gastrointestinal symptoms and absorption may be insufficient in intestinal inflammation. Even where oral iron is successful, repletion of iron stores can be unacceptably slow. Intravenous iron compounds were in the past associated with serious adverse reactions and historically were considered a last resort in children. New generation preparations have a safer profile in adults, although reluctance to use them in children may persist, where safety data are lacking. We investigate the safety and efficacy of ferric carboxymaltose and iron sucrose in children. Methods We retrospectively identified all children with IBD who received parenteral iron over a 38‐month period in a single regional referral centre. Safety, tolerability and adverse events were established by case note review. Efficacy was assessed by change in haematinic indices pre‐ and post‐treatment. Results Forty‐one children (18 male; median age 14 years, range 3–17) received a total of 104 iron infusions. Of these, 44% (18) had Crohn's disease; 56% (23) ulcerative colitis. Thirty‐five received ferric carboxymaltose, seven iron sucrose and one both. Three children developed mild rash post infusion which resolved quickly with chlorphenamine. Mean increase in haemoglobin was 2.5 g dl –1 (0.3–5.8). Iron levels increased by a mean of 8.4 g dl –1 (1–25), transferrin saturation by 16.2% (2–47). Transferrin decreased by 0.84 g dl –1 (0.3–3.4). Conclusions New generation parenteral iron preparations are safe, well tolerated and efficacious in children with iron deficiency anaemia and IBD.