Cargando…
Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study
No information is available on the efficacy of ferric carboxymaltose (FCM) in real-world CKD patients outside the hemodialysis setting. We prospectively followed 59 non-hemodialysis CKD patients with iron deficient anemia (IDA: hemoglobin <12.0/<13.5 g/dL in women/men and TSAT < 20% and/or...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005153/ https://www.ncbi.nlm.nih.gov/pubmed/33806864 http://dx.doi.org/10.3390/jcm10061322 |
_version_ | 1783672068672323584 |
---|---|
author | Minutolo, Roberto Berto, Patrizia Liberti, Maria Elena Peruzzu, Nicola Borrelli, Silvio Netti, Antonella Garofalo, Carlo Conte, Giuseppe De Nicola, Luca Del Vecchio, Lucia Locatelli, Francesco |
author_facet | Minutolo, Roberto Berto, Patrizia Liberti, Maria Elena Peruzzu, Nicola Borrelli, Silvio Netti, Antonella Garofalo, Carlo Conte, Giuseppe De Nicola, Luca Del Vecchio, Lucia Locatelli, Francesco |
author_sort | Minutolo, Roberto |
collection | PubMed |
description | No information is available on the efficacy of ferric carboxymaltose (FCM) in real-world CKD patients outside the hemodialysis setting. We prospectively followed 59 non-hemodialysis CKD patients with iron deficient anemia (IDA: hemoglobin <12.0/<13.5 g/dL in women/men and TSAT < 20% and/or ferritin < 100 ng/mL) who were intolerant or non-responders to oral iron. Patients received ferric carboxymaltose (FCM) (single dose of 500 mg) followed by additional doses if iron deficiency persisted. We evaluated efficacy of FCM in terms of increase of hemoglobin, ferritin, and TSAT levels. Direct and indirect costs of FCM were also analyzed in comparison with a hypothetical scenario where same amount of iron as ferric gluconate (FG) was administered intravenously. During the 24 weeks of study, 847 ± 428 mg of FCM per patient were administered. IDA improved after four weeks of FCM and remained stable thereafter. At week-24, mean change (95%CI) from baseline of hemoglobin, ferritin and TSAT were +1.16 g/dL (0.55–1.77), +104 ng/mL (40–168) and +9.5% (5.8–13.2), respectively. These changes were independent from ESA use and clinical setting (non-dialysis CKD, peritoneal dialysis and kidney transplant). Among ESA-treated patients (n = 24), ESA doses significantly decreased by 26% with treatment and stopped either temporarily or persistently in nine patients. FCM, compared to a FG-based scenario, was associated with a cost saving of 288 euros/patient/24 weeks. Saving was the same in ESA users/non-users. Therefore, in non-hemodialysis CKD patients, FCM effectively corrects IDA and allows remarkable cost savings in terms of societal, healthcare and patient perspective. |
format | Online Article Text |
id | pubmed-8005153 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-80051532021-03-29 Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study Minutolo, Roberto Berto, Patrizia Liberti, Maria Elena Peruzzu, Nicola Borrelli, Silvio Netti, Antonella Garofalo, Carlo Conte, Giuseppe De Nicola, Luca Del Vecchio, Lucia Locatelli, Francesco J Clin Med Article No information is available on the efficacy of ferric carboxymaltose (FCM) in real-world CKD patients outside the hemodialysis setting. We prospectively followed 59 non-hemodialysis CKD patients with iron deficient anemia (IDA: hemoglobin <12.0/<13.5 g/dL in women/men and TSAT < 20% and/or ferritin < 100 ng/mL) who were intolerant or non-responders to oral iron. Patients received ferric carboxymaltose (FCM) (single dose of 500 mg) followed by additional doses if iron deficiency persisted. We evaluated efficacy of FCM in terms of increase of hemoglobin, ferritin, and TSAT levels. Direct and indirect costs of FCM were also analyzed in comparison with a hypothetical scenario where same amount of iron as ferric gluconate (FG) was administered intravenously. During the 24 weeks of study, 847 ± 428 mg of FCM per patient were administered. IDA improved after four weeks of FCM and remained stable thereafter. At week-24, mean change (95%CI) from baseline of hemoglobin, ferritin and TSAT were +1.16 g/dL (0.55–1.77), +104 ng/mL (40–168) and +9.5% (5.8–13.2), respectively. These changes were independent from ESA use and clinical setting (non-dialysis CKD, peritoneal dialysis and kidney transplant). Among ESA-treated patients (n = 24), ESA doses significantly decreased by 26% with treatment and stopped either temporarily or persistently in nine patients. FCM, compared to a FG-based scenario, was associated with a cost saving of 288 euros/patient/24 weeks. Saving was the same in ESA users/non-users. Therefore, in non-hemodialysis CKD patients, FCM effectively corrects IDA and allows remarkable cost savings in terms of societal, healthcare and patient perspective. MDPI 2021-03-23 /pmc/articles/PMC8005153/ /pubmed/33806864 http://dx.doi.org/10.3390/jcm10061322 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Minutolo, Roberto Berto, Patrizia Liberti, Maria Elena Peruzzu, Nicola Borrelli, Silvio Netti, Antonella Garofalo, Carlo Conte, Giuseppe De Nicola, Luca Del Vecchio, Lucia Locatelli, Francesco Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study |
title | Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study |
title_full | Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study |
title_fullStr | Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study |
title_full_unstemmed | Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study |
title_short | Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study |
title_sort | ferric carboxymatose in non-hemodialysis ckd patients: a longitudinal cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005153/ https://www.ncbi.nlm.nih.gov/pubmed/33806864 http://dx.doi.org/10.3390/jcm10061322 |
work_keys_str_mv | AT minutoloroberto ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT bertopatrizia ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT libertimariaelena ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT peruzzunicola ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT borrellisilvio ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT nettiantonella ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT garofalocarlo ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT contegiuseppe ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT denicolaluca ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT delvecchiolucia ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy AT locatellifrancesco ferriccarboxymatoseinnonhemodialysisckdpatientsalongitudinalcohortstudy |