Article: Hypophosphorémie après traitement par fer injectable chez l’adulte : comparaison entre le carboxymaltose ferrique et l’hydroxyde ferrique-saccharose.
Annales pharmaceutiques francaises
2023 Volume 81, Issue 5, Page(s) 790–800
Abstract: Hypophosphatemia is a recognized side effect of treatment of iron deficiency anemias with injectable iron. We analyzed 35 clinical trials that used ferric carboxymaltose (FCM) or iron sucrose (IS). Hypophosphatemia prevalence ranged from 0 to 91.7%. FCM- ... ...
| Title translation | Hypophosphatemia after injectable iron treatments in adults: Comparison between ferric carboxymaltose and iron sucrose. |
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| Abstract | Hypophosphatemia is a recognized side effect of treatment of iron deficiency anemias with injectable iron. We analyzed 35 clinical trials that used ferric carboxymaltose (FCM) or iron sucrose (IS). Hypophosphatemia prevalence ranged from 0 to 91.7%. FCM-induced a significant (P<0.001) greater hypophosphatemia prevalence and phosphatemia decrease than IS (52.0% [95% CI: 42.2-61.8%] vs. 7.7% [95% CI: -2.8 to 18.2%] and -1.12mmol/L [95% CI: -1.36 to -0.89mmol/L] vs. -0.13mmol/L [95% CI: -0.59 to 0.32mmol/L]). FCM-induced hypophosphatemia was dose-dependent. The nadir of hypophosphatemia was reached in almost all studies after 7 and 14days. Hypophosphatemia persisted at the end of the study in 53.8% of the reported studies that used FCM and lasted up to 6months. FCM-induced an increase in intact circulating fibroblast growth factor 23 and in renal phosphorus excretion while serum 1-25 dihydroxyvitamin D was decreased. Risk factors for hypophosphatemia after FCM therapy were low basal circulating phosphate or ferritin, low body weight, high glomerular filtration rate, serum parathyroid hormone or hemoglobin and age, whereas renal insufficiency was associated with a lower risk. In conclusion, hypophosphatemia is common after treatment with injectable iron, FCM being associated with a higher risk than IS and with disorders of phosphocalcium metabolism. Monitoring of blood phosphate and 1-25 dihydroxyvitamin D could be considered during FCM therapy. |
| MeSH term(s) | Adult ; Humans ; Iron/adverse effects ; Ferric Oxide, Saccharated/adverse effects ; Hypophosphatemia/chemically induced ; Hypophosphatemia/epidemiology ; Phosphates/adverse effects |
| Chemical Substances | Iron (E1UOL152H7) ; ferric carboxymaltose (6897GXD6OE) ; Ferric Oxide, Saccharated (FZ7NYF5N8L) ; Phosphates |
| Language | French |
| Publishing date | 2023-03-22 |
| Publishing country | France |
| Document type | English Abstract ; Journal Article ; Review |
| ZDB-ID | 307-4 |
| ISSN | 0003-4509 |
| ISSN | 0003-4509 |
| DOI | 10.1016/j.pharma.2023.03.003 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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