Ferric carboxymaltose treatment for iron deficiency anemia in children with inflammatory bowel disease: Efficacy and risk of hypophosphatemia

• DOI: 10.1016/j.dld.2021.02.017
• Publication Date: 2021-03-27T02:07:13Z
• Authors: Lucia Cococcioni; Licia Pensabene; Sara El-Khouly; Sibongile Chadokufa; Sara McCartney; Efstratios Saliak...; Fevronia Kiparissi; Osvaldo Borrelli
• Keywords: Male; Adolescent; Anemia, Iron-Deficiency; Hypophosphatemia; Iron; Inflammatory Bowel Diseases; Ferric Compounds; Severity of Illness Index; Phosphates; 3. Good health; Hemoglobins; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Risk Factors; Child, Preschool; Ferritins; Prevalence; Humans; Administration, Intravenous; Female; Child; Maltose

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.We assessed the efficacy of FCM and the rate of post-infusion hypophosphatemia in a large cohort of children with IBD and IDA.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.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.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.