Drug‐specific hypophosphatemia and hypersensitivity reactions following different intravenous iron infusions
Aims Intravenous (IV) iron infusions have been associated with hypophosphataemia (HP) and hypersensitivity reactions (HSRs). No studies have compared the side effects of ferric carboxymaltose (FCM) with those of isomaltoside 1000 (ISM). This study aimed to describe the occurrence of HP and HSRs foll...
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| Veröffentlicht in: | British journal of clinical pharmacology 2017-05, Vol.83 (5), p.1118-1125 |
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| creator | Bager, Palle Hvas, Christian L. Dahlerup, Jens F. |
| description | Aims
Intravenous (IV) iron infusions have been associated with hypophosphataemia (HP) and hypersensitivity reactions (HSRs). No studies have compared the side effects of ferric carboxymaltose (FCM) with those of isomaltoside 1000 (ISM). This study aimed to describe the occurrence of HP and HSRs following the administration of either FCM or ISM.
Methods
Data on 231 outpatients treated with IV iron infusions, between November 2011 and April 2014, were collected. During that period, the department made a switch from FCM to ISM and then back to FCM. Of the 231 patients, 39 received both FCM and ISM during the period. The prevalences of HP and HSRs were compared between the two drugs.
Results
We found more HP events when FCM was given (64 vs. 9; P |
| doi_str_mv | 10.1111/bcp.13189 |
| format | Article |
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Intravenous (IV) iron infusions have been associated with hypophosphataemia (HP) and hypersensitivity reactions (HSRs). No studies have compared the side effects of ferric carboxymaltose (FCM) with those of isomaltoside 1000 (ISM). This study aimed to describe the occurrence of HP and HSRs following the administration of either FCM or ISM.
Methods
Data on 231 outpatients treated with IV iron infusions, between November 2011 and April 2014, were collected. During that period, the department made a switch from FCM to ISM and then back to FCM. Of the 231 patients, 39 received both FCM and ISM during the period. The prevalences of HP and HSRs were compared between the two drugs.
Results
We found more HP events when FCM was given (64 vs. 9; P < 0.01). In contrast, more patients had mild HSRs when ISM was given (2.5% vs. 10.7%; P < 0.01). A comparison of the two drugs in the subpopulation who received both drug types (n = 39) revealed a difference in phosphate decrease (P < 0.01), with the most marked decrease occurring with FCM. Nine patients who had HSRs were exposed to both drugs. No potential HSR crossover between the two drugs was found.
Conclusion
We found a higher risk of HP with FCM administration when compared to ISM administration. Conversely, we found a higher risk of mild HSRs with ISM administration when compared to FCM administration. The impacts of the two types of side effects should be considered when choosing an IV iron drug.</description><identifier>ISSN: 0306-5251</identifier><identifier>EISSN: 1365-2125</identifier><identifier>DOI: 10.1111/bcp.13189</identifier><identifier>PMID: 27859495</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; anaemia ; Disaccharides - administration & dosage ; Disaccharides - adverse effects ; Drug Hypersensitivity - epidemiology ; Drug Hypersensitivity - etiology ; Drug Safety ; Female ; Ferric Compounds - administration & dosage ; Ferric Compounds - adverse effects ; Humans ; Hypophosphatemia - chemically induced ; Hypophosphatemia - epidemiology ; inflammatory bowel disease ; Infusions, Intravenous ; intravenous iron ; iron deficiency ; Male ; Maltose - administration & dosage ; Maltose - adverse effects ; Maltose - analogs & derivatives ; Middle Aged ; Prevalence ; Retrospective Studies ; Young Adult</subject><ispartof>British journal of clinical pharmacology, 2017-05, Vol.83 (5), p.1118-1125</ispartof><rights>2016 The British Pharmacological Society</rights><rights>2016 The British Pharmacological Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4819-bf9756bd8ac597da15e43b1ef1eda5674cc75c8b72b4a87491d409abdcfb40e73</citedby><cites>FETCH-LOGICAL-c4819-bf9756bd8ac597da15e43b1ef1eda5674cc75c8b72b4a87491d409abdcfb40e73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbcp.13189$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbcp.13189$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27859495$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bager, Palle</creatorcontrib><creatorcontrib>Hvas, Christian L.</creatorcontrib><creatorcontrib>Dahlerup, Jens F.</creatorcontrib><title>Drug‐specific hypophosphatemia and hypersensitivity reactions following different intravenous iron infusions</title><title>British journal of clinical pharmacology</title><addtitle>Br J Clin Pharmacol</addtitle><description>Aims
Intravenous (IV) iron infusions have been associated with hypophosphataemia (HP) and hypersensitivity reactions (HSRs). No studies have compared the side effects of ferric carboxymaltose (FCM) with those of isomaltoside 1000 (ISM). This study aimed to describe the occurrence of HP and HSRs following the administration of either FCM or ISM.
Methods
Data on 231 outpatients treated with IV iron infusions, between November 2011 and April 2014, were collected. During that period, the department made a switch from FCM to ISM and then back to FCM. Of the 231 patients, 39 received both FCM and ISM during the period. The prevalences of HP and HSRs were compared between the two drugs.
Results
We found more HP events when FCM was given (64 vs. 9; P < 0.01). In contrast, more patients had mild HSRs when ISM was given (2.5% vs. 10.7%; P < 0.01). A comparison of the two drugs in the subpopulation who received both drug types (n = 39) revealed a difference in phosphate decrease (P < 0.01), with the most marked decrease occurring with FCM. Nine patients who had HSRs were exposed to both drugs. No potential HSR crossover between the two drugs was found.
Conclusion
We found a higher risk of HP with FCM administration when compared to ISM administration. Conversely, we found a higher risk of mild HSRs with ISM administration when compared to FCM administration. The impacts of the two types of side effects should be considered when choosing an IV iron drug.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>anaemia</subject><subject>Disaccharides - administration & dosage</subject><subject>Disaccharides - adverse effects</subject><subject>Drug Hypersensitivity - epidemiology</subject><subject>Drug Hypersensitivity - etiology</subject><subject>Drug Safety</subject><subject>Female</subject><subject>Ferric Compounds - administration & dosage</subject><subject>Ferric Compounds - adverse effects</subject><subject>Humans</subject><subject>Hypophosphatemia - chemically induced</subject><subject>Hypophosphatemia - epidemiology</subject><subject>inflammatory bowel disease</subject><subject>Infusions, Intravenous</subject><subject>intravenous iron</subject><subject>iron deficiency</subject><subject>Male</subject><subject>Maltose - administration & dosage</subject><subject>Maltose - adverse effects</subject><subject>Maltose - analogs & derivatives</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>0306-5251</issn><issn>1365-2125</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMGO0zAURS0Eop3Cgh9A2bJIayd2HG-QoDAMUiVYwNqynefGKLUjO-0oOz5hvpEvISFQwQJvLF0fn_d0EXpB8JZMZ6dNvyUlqcUjtCZlxfKCFOwxWuMSVzkrGFmhm5S-YTxBFXuKVgWvmaCCrZF_F8_HH98fUg_GWWeyduxD34bUt2qAk1OZ8s0cQkzgkxvcxQ1jFkGZwQWfMhu6Ltw7f8waZy1E8EPm_BDVBXw4p8zF4KfAntOMP0NPrOoSPP99b9DX2_df9nf54dOHj_s3h9zQmohcW8FZpZtaGSZ4owgDWmoClkCjWMWpMZyZWvNCU1VzKkhDsVC6MVZTDLzcoNeLtz_rEzQG5o062Ud3UnGUQTn574t3rTyGi2QUE8GLSfBqEZgYUopgr38JlnPpcipd_ip9Yl_-PexK_ml5AnYLcO86GP9vkm_3nxflTyxAkvk</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>Bager, Palle</creator><creator>Hvas, Christian L.</creator><creator>Dahlerup, Jens F.</creator><general>John Wiley and Sons Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>201705</creationdate><title>Drug‐specific hypophosphatemia and hypersensitivity reactions following different intravenous iron infusions</title><author>Bager, Palle ; Hvas, Christian L. ; Dahlerup, Jens F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4819-bf9756bd8ac597da15e43b1ef1eda5674cc75c8b72b4a87491d409abdcfb40e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>anaemia</topic><topic>Disaccharides - administration & dosage</topic><topic>Disaccharides - adverse effects</topic><topic>Drug Hypersensitivity - epidemiology</topic><topic>Drug Hypersensitivity - etiology</topic><topic>Drug Safety</topic><topic>Female</topic><topic>Ferric Compounds - administration & dosage</topic><topic>Ferric Compounds - adverse effects</topic><topic>Humans</topic><topic>Hypophosphatemia - chemically induced</topic><topic>Hypophosphatemia - epidemiology</topic><topic>inflammatory bowel disease</topic><topic>Infusions, Intravenous</topic><topic>intravenous iron</topic><topic>iron deficiency</topic><topic>Male</topic><topic>Maltose - administration & dosage</topic><topic>Maltose - adverse effects</topic><topic>Maltose - analogs & derivatives</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bager, Palle</creatorcontrib><creatorcontrib>Hvas, Christian L.</creatorcontrib><creatorcontrib>Dahlerup, Jens F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bager, Palle</au><au>Hvas, Christian L.</au><au>Dahlerup, Jens F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Drug‐specific hypophosphatemia and hypersensitivity reactions following different intravenous iron infusions</atitle><jtitle>British journal of clinical pharmacology</jtitle><addtitle>Br J Clin Pharmacol</addtitle><date>2017-05</date><risdate>2017</risdate><volume>83</volume><issue>5</issue><spage>1118</spage><epage>1125</epage><pages>1118-1125</pages><issn>0306-5251</issn><eissn>1365-2125</eissn><abstract>Aims
Intravenous (IV) iron infusions have been associated with hypophosphataemia (HP) and hypersensitivity reactions (HSRs). No studies have compared the side effects of ferric carboxymaltose (FCM) with those of isomaltoside 1000 (ISM). This study aimed to describe the occurrence of HP and HSRs following the administration of either FCM or ISM.
Methods
Data on 231 outpatients treated with IV iron infusions, between November 2011 and April 2014, were collected. During that period, the department made a switch from FCM to ISM and then back to FCM. Of the 231 patients, 39 received both FCM and ISM during the period. The prevalences of HP and HSRs were compared between the two drugs.
Results
We found more HP events when FCM was given (64 vs. 9; P < 0.01). In contrast, more patients had mild HSRs when ISM was given (2.5% vs. 10.7%; P < 0.01). A comparison of the two drugs in the subpopulation who received both drug types (n = 39) revealed a difference in phosphate decrease (P < 0.01), with the most marked decrease occurring with FCM. Nine patients who had HSRs were exposed to both drugs. No potential HSR crossover between the two drugs was found.
Conclusion
We found a higher risk of HP with FCM administration when compared to ISM administration. Conversely, we found a higher risk of mild HSRs with ISM administration when compared to FCM administration. The impacts of the two types of side effects should be considered when choosing an IV iron drug.</abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>27859495</pmid><doi>10.1111/bcp.13189</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over anaemia Disaccharides - administration & dosage Disaccharides - adverse effects Drug Hypersensitivity - epidemiology Drug Hypersensitivity - etiology Drug Safety Female Ferric Compounds - administration & dosage Ferric Compounds - adverse effects Humans Hypophosphatemia - chemically induced Hypophosphatemia - epidemiology inflammatory bowel disease Infusions, Intravenous intravenous iron iron deficiency Male Maltose - administration & dosage Maltose - adverse effects Maltose - analogs & derivatives Middle Aged Prevalence Retrospective Studies Young Adult |
| title | Drug‐specific hypophosphatemia and hypersensitivity reactions following different intravenous iron infusions |
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