Efficacy and safety of ferric derisomaltose injection versus iron sucrose injection in the treatment of iron deficiency anemia in patients with inflammatory bowel disease
10.3760/cma.j.cn311367-20241122-00460
- VernacularTitle:异麦芽糖酐铁注射液与蔗糖铁注射液治疗炎症性肠病合并缺铁性贫血的疗效与安全性对比研究
- Author:
Changqin LIU
1
;
Xiaomin SUN
1
;
Cui ZHANG
1
;
Liang CHEN
1
;
Zhanju LIU
1
Author Information
1. 同济大学附属第十人民医院消化内科,上海 200072
- Publication Type:Journal Article
- Keywords:
Ferric derisomaltose injection;
Iron sucrose injection;
Inflammatory bowel disease;
Anemia, iron-deficiency
- From:
Chinese Journal of Digestion
2025;45(4):241-246
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare and analyze the clinical efficacy and safety of ferric derisomaltose injection (FDI) and iron sucrose injection (ISI) in the treatment of iron deficiency anemia (IDA) in patients with inflammatory bowel disease (IBD).Methods:From January 1, 2023 to August 31, 2024, 89 IBD patients complicated with IDA hospitalized and treated at the Department of Gastroenterology, Tenth People′s Hospital of Tongji University were enrolled and divided into the FDI group (44 cases) and ISI group (45 cases). Patients in the FDI group and ISI group were treated with FDI and ISI, respectively, and the treatment course were both 8 weeks. The iron supplementation dose, number of injections, and efficacy (response rate) were compared between the 2 groups. Hemoglobin (Hb) levels were measured before treatment and at the 2nd, 4th, and 8th week after treatment. After 8 weeks of treatment, the changes in serum iron, C-reactive protein (CRP), Crohn′s disease activity index (CDAI), modified Mayo score, inflammatory bowel disease questionnaire (IBDQ) score, and serum phosphorus levels were compared with those before treatment. Chi-square test, paired t-test, independent sample t-test, Wilcoxon signed-rank test, and Mann-Whitney U test were used for statistical analysis. Results:The difference between required and actual iron supplementation and number of injections of the FDI group were both less than those of the ISI group ((466±264) mg vs. (571±302) mg, 1.0 (1.0, 1.0) vs. 3.0 (2.0, 5.5)), and the differences were statistically significant ( t=3.69, U=104.50; both P<0.001). After 8 weeks of treatment, the efficacy and increase in serum iron of the FDI group were both higher than those of the ISI group (81.8% (36/44) vs. 60.0% (27/45), 7.35 (4.53, 12.68) μmol/L vs. 3.60 (1.10, 8.20) μmol/L), and the differences were statistically significant ( χ2=5.12, U=545.40; P=0.024, <0.001). After 2, 4, and 8 weeks of treatment, the increase in Hb from before treatment of the FDI group were higher than those of the ISI group (22.5 (8.5, 29.0) g/L vs. 7.0 (2.0, 23.5) g/L; 29.5 (22.0, 49.8) g/L vs. 14.0 (6.0, 32.0) g/L; 36.5 (25.5, 60.5) g/L vs. 21.0 (7.0, 42.0) g/L), and the differences were statistically significant ( U=590.00, 518.00, and 584.00; all P<0.001). The reductions in CDAI, modified Mayo score, and CRP, as well as the improvement in IBDQ score before and after treatment were comparable between the FDI group and the ISI group (130.7±70.3 vs. 128.8±74.6, 7.3±2.3 vs. 5.8±3.2, 26.73 (2.44, 63.44) mg/L vs. 7.41 (1.86, 47.39) mg/L, 38.5±28.4 vs. 37.0±28.1), and the differences were not statistically significant (all P>0.05). In the FDI group serum phosphorus levels after 4 and 8 weeks of treatment were both higher than that before treatment (1.27(1.13, 1.45), 1.23(1.13, 1.40) mmol/L vs. 1.21 (1.03, 1.28) mmol/L), and the differences were statistically significant ( Z=539.00 and 454.00, both P<0.001). During the treatment, mild to moderate adverse reactions occurred in 13.6% (6/44) patients of the FDI group and 11.1% (5/45) patients of the ISI group, there were no serious adverse events. Conclusion:FDI can rapidly, effectively, and safely improve IDA in IBD patients without affecting blood phosphate metabolism.