A retrospective review examining intravenous iron infusion dosing methods

Abstract

Background Careful dosing of intravenous iron is important to minimise consequences of iron deficient anaemia, and avoid complications related to iron overload. Clinician practice regarding dosing varies between settings and specialities. Ganzoni dosing is an individualised calculated dose based on patient details and has traditionally been advocated for, while the fixed‐low dose method provides a method for individuals to receive a lower fixed dose of iron. At present, it is unclear if Ganzoni‐dosing compared with a fixed‐low dose provides greater haemoglobin improvements for iron‐deficient patients with reduced haemoglobin. The aim of this study is to explore whether the choice of intravenous iron dosing method influences improvements in the patient’s haemoglobin concentration. Method A retrospective observational study using real‐world data was carried out to compare Ganzoni and fixed‐low dose patients using a cohort of 79 patients between 1 April 2017 and 25 February 2019. The primary outcome of interest was the change in haemoglobin concentration between baseline (within 0–28 days prior to intravenous iron infusion) and follow‐up (4–12 weeks following intravenous iron infusion). Results The Ganzoni and fixed‐low dose methods indicated similar improvements in haemoglobin concentration (17 and 25 g/L, respectively), with no statistically significant differences identified between the two dosing methods for any other clinical indicators assessed. Conclusion This study has indicated that the fixed‐low dose method may be an appropriate alternative to the Ganzoni dosing method for the dosing of iron polymaltose and ferric carboxymaltose for iron deficient patients with reduced haemoglobin.