Incidence of Adverse Events Compared Among IV Iron Compounds

The endpoints were symptoms of hypersensitivity, anaphylaxis, ED visits, hospitalizations, and death
The endpoints were symptoms of hypersensitivity, anaphylaxis, ED visits, hospitalizations, and death

Ferumoxytol was not associated with an increased risk of adverse reactions compared to other IV iron medications when used to treat iron deficiency anemia in patients without chronic kidney disease (non-CKD) as well as in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD), according to results of a retrospective cohort study.                  

The study authors identified non-CKD and NDD-CKD patients in the Medicare 20% random sample who received their first IV iron dose between 2010 and 2012. IV iron medication exposures included ferumoxytol, iron sucrose, sodium ferric gluconate, and iron dextran. Study endpoints were symptoms of hypersensitivity, anaphylaxis, emergency department (ED) visits, hospitalizations, and death following acute IV iron administration. 

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Results showed there was no difference in hypersensitivity symptoms (hazard ratio 1.04, 95% confidence interval 0.94–1.16) or hypotension (0.83, 0.52–1.34) between 4289 non-CKD ferumoxytol users and the same number of users of other compounds. The 7358 NDD-CKD patients had similar results.

It was also found that fewer all-cause ED visits or hospitalizations occurred in non-CKD patients (HR: 0.56; 95% CI: 0.45, 0.70) as well as in NDD-CKD patients (HR: 0.83; 95% CI: 0.71, 0.95) treated with ferumoxytol.

“Fewer than 10 deaths occurred in both the non-CKD and NDD-CKD ferumoxytol users and in matched controls,” wrote the authors. They also stated that the hazard ratio for death was not found to be significantly different between non-CKD (HR: 2.00; 95% CI: 0.33, 11.97) and NDD-CKD patients (HR: 0.25; 95% CI: 0.04, 1.52) treated with ferumoxytol. 

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