Iron Sucrose: A Wealth of Experience in Treating Iron Deficiency
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REVIEW
Iron Sucrose: A Wealth of Experience in Treating Iron Deficiency Iain C. Macdougall . Josep Comin-Colet . Christian Breymann . Donat R. Spahn . Ioannis E. Koutroubakis
Received: February 18, 2020 Ó The Author(s) 2020
ABSTRACT Iron deficiency and iron-deficiency anemia are associated with increased morbidity and mortality in a wide range of conditions. In many patient populations, this can be treated effectively with oral iron supplementation; but in patients who are unable to take or who do not respond to oral iron therapy, intravenous iron administration is recommended. Furthermore,
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12030552. I. C. Macdougall (&) Department of Renal Medicine, King’s College Hospital, London, UK e-mail: [email protected] J. Comin-Colet Department of Cardiology, Bellvitge University Hospital and IDIBELL, University of Barcelona, Barcelona, Spain C. Breymann ¨ rich, Perinatal and Gynecology Center Seefeld Zu Zurich, Switzerland D. R. Spahn Institute of Anaesthesiology, University of Zurich ¨ rich, Zurich, Switzerland and University Hospital Zu I. E. Koutroubakis Department of Gastroenterology, University Hospital Heraklion, Crete, Greece
in certain conditions, such as end-stage kidney disease, chronic heart failure, and inflammatory bowel disease, intravenous iron administration has become first-line treatment. One of the first available intravenous iron preparations is iron sucrose (VenoferÒ), a nanomedicine that has been used clinically since 1949. Treatment with iron sucrose is particularly beneficial owing to its ability to rapidly increase hemoglobin, ferritin, and transferrin saturation levels, with an acceptable safety profile. Recently, important new data relating to the use of iron sucrose, including the findings from the landmark PIVOTAL trial in patients with end-stage kidney disease, have been reported. Several years ago, a number of iron sucrose similars became available, although there have been concerns about the clinical appropriateness of substituting the original iron sucrose with an iron sucrose similar because of differences in efficacy and safety. This is a result of the complex and unique physicochemical properties of nanomedicines such as iron sucrose, which make copying the molecule difficult and problematic. In this review, we summarize the evidence accumulated during 70 years of clinical experience with iron sucrose in terms of efficacy, safety, and cost-effectiveness.
Keywords: Anemia; Iron deficiency; sucrose; Nanomedicine; Venofer
Iron
Adv Ther
INTRODUCTION Key Summary Points Intravenously administered (IV) iron is important for individuals who are unable to tolerate oral iron therapy, who are noncompliant with oral treatment, or in whom oral preparations are not effective. One of the first IV iron preparations to be manufactured is iron sucrose (VenoferÒ; Vifor Pharma), which became available for clinical use over 70 years ago in 1949. It is the most commonly used IV iron therap
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