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Questions and answers on iron deficiency treatment selection and the use of intravenous iron in routine clinical practice

Richards, Toby ; Breymann, Christian ; Brookes, Matthew J. ; Lindgren, Stefan LU ; Macdougall, Iain C. ; McMahon, Lawrence P. ; Munro, Malcolm G. ; Nemeth, Elizabeta ; Rosano, Giuseppe M.C. and Schiefke, Ingolf , et al. (2021) In Annals of Medicine 53(1). p.274-285
Abstract

Iron deficiency is a common cause of morbidity and can arise as a consequence or complication from many diseases. The use of intravenous iron has increased significantly in the last decade, but concerns remain about indications and administration. Modern intravenous iron preparations can facilitate rapid iron repletion in one or two doses, both for absolute iron deficiency and, in the presence of inflammation, functional iron deficiency, where oral iron therapy is ineffective or has not worked. A multidisciplinary team of experts experienced in iron deficiency undertook a consensus review to support healthcare professionals with practical advice on managing iron deficiency in gastrointestinal, renal and cardiac disease, as well as;... (More)

Iron deficiency is a common cause of morbidity and can arise as a consequence or complication from many diseases. The use of intravenous iron has increased significantly in the last decade, but concerns remain about indications and administration. Modern intravenous iron preparations can facilitate rapid iron repletion in one or two doses, both for absolute iron deficiency and, in the presence of inflammation, functional iron deficiency, where oral iron therapy is ineffective or has not worked. A multidisciplinary team of experts experienced in iron deficiency undertook a consensus review to support healthcare professionals with practical advice on managing iron deficiency in gastrointestinal, renal and cardiac disease, as well as; pregnancy, heavy menstrual bleeding, and surgery. We explain how intravenous iron may work where oral iron has not. We provide context on how and when intravenous iron should be administered, and informed opinion on potential benefits balanced with potential side-effects. We propose how intravenous iron side-effects can be anticipated in terms of what they may be and when they may occur. The aim of this consensus is to provide a practical basis for educating and preparing staff and patients on when and how iron infusions can be administered safely and efficiently.Key messages Iron deficiency treatment selection is driven by several factors, including the presence of inflammation, the time available for iron replenishment, and the anticipated risk of side-effects or intolerance. Intravenous iron preparations are indicated for the treatment of iron deficiency when oral preparations are ineffective or cannot be used, and therefore have applicability in a wide range of clinical contexts, including chronic inflammatory conditions, perioperative settings, and disorders associated with chronic blood loss. Adverse events occurring with intravenous iron can be anticipated according to when they typically occur, which provides a basis for educating and preparing staff and patients on how iron infusions can be administered safely and efficiently.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anaemia, cardiovascular diseases, chronic, erythrocyte transfusion, inflammatory bowel diseases, infusions, intravenous, iron, iron-deficiency, menorrhagia, pregnancy complications, renal insufficiency
in
Annals of Medicine
volume
53
issue
1
pages
12 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85099291148
  • pmid:33426933
ISSN
0785-3890
DOI
10.1080/07853890.2020.1867323
language
English
LU publication?
yes
id
5432b793-2d7e-4c81-8694-9dc2cec9f47e
date added to LUP
2021-01-25 14:05:12
date last changed
2024-06-13 06:14:36
@article{5432b793-2d7e-4c81-8694-9dc2cec9f47e,
  abstract     = {{<p>Iron deficiency is a common cause of morbidity and can arise as a consequence or complication from many diseases. The use of intravenous iron has increased significantly in the last decade, but concerns remain about indications and administration. Modern intravenous iron preparations can facilitate rapid iron repletion in one or two doses, both for absolute iron deficiency and, in the presence of inflammation, functional iron deficiency, where oral iron therapy is ineffective or has not worked. A multidisciplinary team of experts experienced in iron deficiency undertook a consensus review to support healthcare professionals with practical advice on managing iron deficiency in gastrointestinal, renal and cardiac disease, as well as; pregnancy, heavy menstrual bleeding, and surgery. We explain how intravenous iron may work where oral iron has not. We provide context on how and when intravenous iron should be administered, and informed opinion on potential benefits balanced with potential side-effects. We propose how intravenous iron side-effects can be anticipated in terms of what they may be and when they may occur. The aim of this consensus is to provide a practical basis for educating and preparing staff and patients on when and how iron infusions can be administered safely and efficiently.Key messages Iron deficiency treatment selection is driven by several factors, including the presence of inflammation, the time available for iron replenishment, and the anticipated risk of side-effects or intolerance. Intravenous iron preparations are indicated for the treatment of iron deficiency when oral preparations are ineffective or cannot be used, and therefore have applicability in a wide range of clinical contexts, including chronic inflammatory conditions, perioperative settings, and disorders associated with chronic blood loss. Adverse events occurring with intravenous iron can be anticipated according to when they typically occur, which provides a basis for educating and preparing staff and patients on how iron infusions can be administered safely and efficiently.</p>}},
  author       = {{Richards, Toby and Breymann, Christian and Brookes, Matthew J. and Lindgren, Stefan and Macdougall, Iain C. and McMahon, Lawrence P. and Munro, Malcolm G. and Nemeth, Elizabeta and Rosano, Giuseppe M.C. and Schiefke, Ingolf and Weiss, Günter}},
  issn         = {{0785-3890}},
  keywords     = {{Anaemia; cardiovascular diseases; chronic; erythrocyte transfusion; inflammatory bowel diseases; infusions; intravenous; iron; iron-deficiency; menorrhagia; pregnancy complications; renal insufficiency}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{274--285}},
  publisher    = {{Taylor & Francis}},
  series       = {{Annals of Medicine}},
  title        = {{Questions and answers on iron deficiency treatment selection and the use of intravenous iron in routine clinical practice}},
  url          = {{http://dx.doi.org/10.1080/07853890.2020.1867323}},
  doi          = {{10.1080/07853890.2020.1867323}},
  volume       = {{53}},
  year         = {{2021}},
}