Banner - About IDA

Treating and Managing IDA

Overall, the treatment of IDA consists of remedying the underlying etiology and replenishing iron stores.14

IDA treatment goals15

  • Correct the anemia
  • Prevent a further fall in hemoglobin (Hb)
  • Avoid the use of blood transfusions
  • Increase Hb, serum ferritin, and transferrin saturation (TSAT) above the lower threshold of normal

IDA requires ongoing care to ensure iron levels stay where they need to be. Until a patient's iron returns to a sufficient level, which can take time depending on which therapy they are on, they may still experience symptoms like fatigue.

IDA requires ongoing care to ensure iron levels stay where they need to be. Until a patient's iron returns to a sufficient level, which can take time depending on which therapy they are on, they may still experience symptoms like fatigue.

Two common treatment options are oral and intravenous iron.1

IDA management and treatment options

IDA management and treatment options

Currently there is no consensus regarding the most appropriate iron deficit repletion dosing in patients with IDA. Treating and managing IDA is up to your clinical guidance and discretion. In patients you suspect are at risk for IDA, IDA can be assessed through laboratory measurements. Common laboratory markers are Hb, serum ferritin, and TSAT. As a reference point, take a look at the key laboratory markers that are key to evaluation. Click here to see how factors may vary in your practice.

There's more to evaluating IDA than hemoglobin levels

There's more to evaluating IDA than hemoglobin levels

3 key indices for evaluating IDA

The Injectafer clinical trials looked at absolute change in Hb as the primary
endpoint—and also assessed changes in ferritin and TSAT as secondary endpoints.16,17

SEE THE DATA

There are no established US clinical guidelines for treating and managing IDA. When you have a patient present with IDA symptoms such as fatigue and shortness of breath, you could consider:

  • Further laboratory assessment
  • Nutritional support
  • Iron supplementation
    • A potential oral iron treatment may include 325 mg of ferrous sulfate, 1-3 times a day18,19
    • A month may be enough time to expect an improvement in Hb of 1-2 g/dL, although a complete response may take longer6,15,20

There is no consensus on proper follow-up time parameters to assess if oral iron is working, as each patient is different. Use your discretion to decide if oral iron is right for your patients based on their response and tolerance to medicine.

There is no consensus on proper follow-up time parameters to assess if oral iron is working, as each patient is different. Use your discretion to decide if oral iron is right for your patients based on their response and tolerance to medicine.

Patients with IDA may fail oral iron for a number of reasons

Patients with IDA may fail oral iron for a number of reasons

Poor absorption: A wide variety of inflammatory conditions can elevate hepcidin,
hindering oral iron absorption and reducing serum iron levels.21

Poor absorption: A wide variety of inflammatory conditions can elevate hepcidin, hindering oral iron absorption and reducing serum iron levels.21

Oral Iron Therapy Issues Icon

Adherence issues

Oral Iron Therapy Adherence Rate Icon

Data show the adherence rate for oral iron therapy is
40%-60%.22
Adherence may be affected by side effects.20

Side effects

Oral Iron Therapy Side Effects Icon

10%-40% of patients taking oral iron may experience side effects, which could necessitate reduction of dose or dosing frequency.23

Adverse reactions reported by ≥2% of Injectafer-­treated patients were nausea (7.2%); hypertension (3.8%); flushing/hot flush (3.6%); blood phosphorus decrease (2.1%); and dizziness (2.0%).24

When oral iron fails, its time to consider IV iron

When oral iron fails, it's time to consider IV iron

100% of IV iron is delivered into the patient's bloodstream

100% of IV iron is delivered into the patient's bloodstream

  • The full dose of IV iron is available to be utilized in hemoglobin production or stored as ferritin for future use as hemoglobin is depleted.

IV Iron Therapy Delivers 100% Iron Into Bloodstream

CHOOSING INJECTAFER

CHOOSING INJECTAFER

Important Safety Information

INDICATIONS

Injectafer® (ferric carboxymaltose injection) is an iron replacement product indicated for the treatment of iron deficiency anemia (IDA) in adult patients who have intolerance to oral iron or have had unsatisfactory response to oral iron, and in adult patients with non-dialysis dependent chronic kidney disease.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

Injectafer is contraindicated in patients with hypersensitivity to Injectafer or any of its inactive components.

WARNINGS AND PRECAUTIONS

Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, have been reported in patients receiving Injectafer. Patients may present with shock, clinically significant hypotension, loss of consciousness, and/or collapse. Monitor patients for signs and symptoms of hypersensitivity during and after Injectafer administration for at least 30 minutes and until clinically stable following completion of the infusion. Only administer Injectafer when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions.In clinical trials, serious anaphylactic/anaphylactoid reactions were reported in 0.1% (2/1775) of subjects receiving Injectafer. Other serious or severe adverse reactions potentially associated with hypersensitivity which included, but were not limited to, pruritus, rash, urticaria, wheezing, or hypotension were reported in 1.5% (26/1775) of these subjects.

In clinical studies, hypertension was reported in 3.8% (67/1775) of subjects. Transient elevations in systolic blood pressure, sometimes occurring with facial flushing, dizziness, or nausea were observed in 6% (106/1775) of subjects. These elevations generally occurred immediately after dosing and resolved within 30 minutes. Monitor patients for signs and symptoms of hypertension following each Injectafer administration.

In the 24 hours following administration of Injectafer, laboratory assays may overestimate serum iron and transferrin bound iron by also measuring the iron in Injectafer.

ADVERSE REACTIONS

In two randomized clinical studies, a total of 1775 patients were exposed to Injectafer, 15 mg/kg of body weight, up to a single maximum dose of 750 mg of iron on two occasions, separated by at least 7 days, up to a cumulative dose of 1500 mg of iron. Adverse reactions reported by ≥2% of Injectafer-treated patients were nausea (7.2%); hypertension (3.8%); flushing/hot flush (3.6%); blood phosphorus decrease (2.1%); and dizziness (2.0%).

The following serious adverse reactions have been most commonly reported from the post-marketing spontaneous reports: urticaria, dyspnea, pruritus, tachycardia, erythema, pyrexia, chest discomfort, chills, angioedema, back pain, arthralgia, and syncope.

To report adverse events, please contact American Regent at 1-800-734-9236. You may also contact the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Please see Full Prescribing Information.

References - About IDA