(HealthDay News) — The risk of anaphylaxis associated with first exposure to intravenous (IV) iron is highest for iron dextran and lowest for iron sucrose, according to a study published in the Nov. 17 issue of the Journal of the American Medical Association.

Cunlin Wang, M.D., Ph.D., from the U.S. Food and Drug Administration in Silver Spring, Md., and colleagues compared the risk of anaphylaxis among marketed IV iron products. Data were included for 688,183 new users of IV iron.

The researchers identified 274 anaphylaxis cases at first exposure, with 170 additional incident anaphylaxis cases identified during subsequent administrations. The risk for anaphylaxis at first exposure was 68 and 24 per 100,000 persons for iron dextran and all nondextran IV iron products, respectively, with an adjusted odds ratio of 2.6 (P < 0.001). Compared with iron sucrose, the adjusted odds ratio for anaphylaxis at first exposure was 3.6 for iron dextran, 2.0 for iron gluconate, and 2.2 for ferumoxytol. Following total iron repletion of 1,000 mg administered within a 12-week period, the estimated cumulative anaphylaxis risk was highest with iron dextran and lowest with iron sucrose (82 and 21 per 100,000 persons, respectively).

“Among patients in the U.S. Medicare nondialysis population with first exposure to IV iron, the risk of anaphylaxis was highest for iron dextran and lowest for iron sucrose,” the authors write.

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