Efficacy and Safety of Treatment With Ferric Carboxymaltose in Patients With Cirrhosis and Gastrointestinal Bleeding

Frontiers in Medicine

article

Raquel Ballester-Clau¹  Gisela Torres Vicente¹  Mercedes Cucala Ramos³  Carles Aracil Blanch¹  Josep Maria Miñana Calafat¹  Eva Pijoan Comas¹  Josep Maria Reñé Espinet¹  Montse Planella de Rubinat¹ 

[1] Department of Gastroenterology, University Hospital Arnau de Vilanova;Biomedical Research Institute of Lleida;Medical Department

关键词: liver cirrhosis;    gastrointestinal bleeding (GIB);    intravenous iron (i.v.);    ferric carboxymaltose (FCM);    blood transfusion;   

DOI  :  10.3389/fmed.2020.00128

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Patients with liver cirrhosis and gastrointestinal bleeding (GIB) often develop anemia. Ferric carboxymaltose (FCM) is an intravenous (i.v.) iron formulation approved for use in patients with iron deficiency with inadequate response to oral iron therapy or when oral iron cannot be used. Here we analyzed the efficacy and safety of FCM treatment in cirrhotic patients with anemia and GIB. Methods: Retrospective observational study of patients with cirrhosis and acute or chronic GIB treated with 1,000 mg FCM at the University Hospital Arnau de Vilanova (Lleida, Spain) that follows a restrictive-transfusion strategy. All data were obtained from the patients' medical records. We used the Wilcoxon test to evaluate statistical significance. Results: Patients with cirrhosis and GIB ( n = 34) were treated with 1,000 mg FCM. Portal hypertension were present in 88.2% of the patients. For hospitalized patients ( n = 21), median serum hemoglobin (s-Hb) levels increased by 3.0 g/dL ( p < 0.02) and 3.9 g/dL ( p < 0.07) for patients treated with FCM who had or had not received also a transfusion, respectively, compared to levels recorded upon admission. For outpatients ( n = 13) the mean s-Hb levels was 9.8 ± 1.6 g/dL before FCM treatment and 11.3 ± 2.1 g/dL after treatment, demonstrating a mean increase of 1.5 g/dL ( p < 0.001). No serious adverse reactions to FCM were observed. Conclusion: FCM administration achieved optimal s-Hb levels in most cirrhotic patients with acute or chronic GIB, suggesting that early FCM infusion improves and maintains optimal s-Hb levels in these patients and may be an appropriate first-line therapy to treat their anemia.

【 授权许可】

CC BY