AIM HD-CKD study: assessment of the efficacy and safety of ferric carboxymaltose in iron deficiency anemia management in haemodialysis patients with chronic kidney disease

Authors

  • Umesh Khanna Department of Nephrology, Founder & Director of Kidney Associates, Mumbai, Maharashtra, India
  • Pavan Kumar Perugu Department of Nephrology & Transplant Physician, Capital Hospitals, Vijayawada Road, Poranki, Vijayawada, Andhra Pradesh, India
  • Arun Kumar Department of Nephrology & Transplant Physician, Apollo Hospitals, Bengaluru, Karnataka, India
  • Sharad Sheth Department of Nephrology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
  • Ankush Gaikwad Department of Emcure Pharmaceuticals Ltd, 5th Floor, Wing D, Oberoi Garden State, Andheri East Mumbai, Maharashtra, India
  • Priti Gajbe Department of Emcure Pharmaceuticals Ltd, 5th Floor, Wing D, Oberoi Garden State, Andheri East Mumbai, Maharashtra, India
  • Prajakta Wangikar Department of Emcure Pharmaceuticals Ltd, 5th Floor, Wing D, Oberoi Garden State, Andheri East Mumbai, Maharashtra, India
  • Sachin Suryawanshi Department of Emcure Pharmaceuticals Ltd, 5th Floor, Wing D, Oberoi Garden State, Andheri East Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20251203

Keywords:

Ferritin, Iron deficiency anemia, Chronic kidney disease, Efficacy, Safety, Hemodialysis, Hemoglobin

Abstract

Background: Iron deficiency anemia (IDA) is a common complication in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD). Intravenous (IV) iron supplementation is essential for managing IDA in these patients, and ferric carboxymaltose (FCM) has emerged as a promising treatment option.

Methods: This multicentric, retrospective observational study was conducted from April to August 2023, involving 52 adult HD-CKD patients with IDA in India. During dialysis sessions, 48 patients received 4 weekly doses of 100 mg FCM IV push, while 4 patients received 3 doses. Hematological parameters, including haemoglobin (Hb), serum ferritin, transferrin saturation (TSAT), C-reactive protein (CRP), and estimated glomerular filtration rate (eGFR), were measured at baseline and after the final FCM dose. The primary outcome was the change in Hb levels, with secondary outcomes focusing on changes in ferritin, TSAT, CRP, eGFR, and the safety profile of FCM.

Results: Following FCM administration, a significant increase was observed in Hb levels (+0.69 g/dl, p<0.001), serum ferritin (+8.61 ng/ml, p=0.003), and TSAT (+3.69%, p<0.001). CRP levels showed a slight, non-significant decrease, while eGFR slightly increased, and neither reached statistical significance. No serious adverse events were reported, indicating a favorable safety profile for FCM.

Conclusion: The study demonstrated that 100 mg IV FCM is an effective and safe treatment for managing iron deficiency anemia in Indian HD-CKD patients. The significant improvement in Hb, ferritin, and TSAT levels post-FCM administration supports its use as a reliable therapeutic option in this patient population.

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References

Lacquaniti A, Pasqualetti P, Tocco TC di, Campo S, Rovito S, Bucca M, et al. Ferric carboxymaltose versus ferric gluconate in hemodialysis patients: Reduction of erythropoietin dose in 4 years of follow-up. Kidney Res Clin Pract. 2020;39(3):334–43. DOI: https://doi.org/10.23876/j.krcp.20.015

SCovic A, Mircescu G. The safety and efficacy of intravenous ferric carboxymaltose in anaemic patients undergoing haemodialysis: a multi-centre, open-label, clinical study. Nephrol Dial Transplant. 2010;25(8):2722–30. DOI: https://doi.org/10.1093/ndt/gfq069

Diebold M, Kistler AD. Evaluation of iron stores in hemodialysis patients on maintenance ferric Carboxymaltose dosing. BMC Nephrol. 2019;20(1):76. DOI: https://doi.org/10.1186/s12882-019-1263-8

Auerbach M, Ballard H. Clinical use of intravenous iron: administration, efficacy, and safety. Hematology Am Soc Hematol Educ Program. 2010;2010:338–47. DOI: https://doi.org/10.1182/asheducation-2010.1.338

Bregman DB, Goodnough LT. Experience with intravenous ferric carboxymaltose in patients with iron deficiency anemia. Ther Adv Hematol. 2014;5(2):48–60. DOI: https://doi.org/10.1177/2040620714521127

Charytan C, Bernardo M V, Koch TA, Butcher A, Morris D, Bregman DB. Intravenous ferric carboxymaltose versus standard medical care in the treatment of iron deficiency anemia in patients with chronic kidney disease: a randomized, active-controlled, multi-center study. Nephrol Dial Transplant. 2013;28(4):953–64. DOI: https://doi.org/10.1093/ndt/gfs528

Rognoni C, Ortalda V, Biasi C, Gambaro G. Economic Evaluation of ferric carboxymaltose for the management of haemodialysis patients with iron deficiency anemia in Italy. Adv Ther. 2019;36(11):3253–64. DOI: https://doi.org/10.1007/s12325-019-01089-z

Kidney Disease: Improving Global Outcomes (KDIGO) anemia work group. KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney. 2012;2:279–335.

Tagboto S, Cropper L, Turner J, Pugh-Clarke K. The efficacy of a single dose of intravenous ferric carboxymaltose (Ferinject) on anaemia in a pre-dialysis population of chronic kidney disease patients. J Ren Care. 2009;35(1):18–23. DOI: https://doi.org/10.1111/j.1755-6686.2009.00075.x

Kliger AS, Foley RN, Goldfarb DS, Goldstein SL, Johansen K, Singh A, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for anemia in CKD. Am J Kidney Dis. 2013;62(5):849–59. DOI: https://doi.org/10.1053/j.ajkd.2013.06.008

Vikrant S, Parashar A. The safety and efficacy of high dose ferric carboxymaltose in patients with chronic kidney disease: A single center study. Indian J Nephrol. 2015;25(4):213–21. DOI: https://doi.org/10.4103/0971-4065.144421

Hofman JMG, Eisenga MF, Diepenbroek A, Nolte IM, van Dam B, Westerhuis R, et al. Switching iron sucrose to ferric carboxymaltose associates to better control of iron status in hemodialysis patients. BMC Nephrol. 2018;19(1):242. DOI: https://doi.org/10.1186/s12882-018-1045-8

Rosati A, Conti P, Berto P, Molinaro S, Baldini F, Egan CG, et al. Efficacy, safety and pharmacoeconomic analysis of intravenous ferric carboxymaltose in anemic hemodialysis patients unresponsive to ferric gluconate treatment: a multicenter retrospective study. J Clin Med. 2022;11(18):5284. DOI: https://doi.org/10.3390/jcm11185284

14. Righini M, Dalmastri V, Capelli I, Orsi C, Donati G, Pallotti MG, et al. Intravenous iron replacement therapy improves cardiovascular outcomes in hemodialysis patients. In Vivo. 2021;35(3):1617–24. DOI: https://doi.org/10.21873/invivo.12419

Laass MW, Straub S, Chainey S, Virgin G, Cushway T. Effectiveness and safety of ferric carboxymaltose treatment in children and adolescents with inflammatory bowel disease and other gastrointestinal diseases. BMC Gastroenterol. 2014;14(1):27. DOI: https://doi.org/10.1186/1471-230X-14-184

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Published

2025-04-28

How to Cite

Khanna, U., Perugu, P. K., Kumar, A., Sheth, S., Gaikwad, A., Gajbe, P., Wangikar, P., & Suryawanshi, S. (2025). AIM HD-CKD study: assessment of the efficacy and safety of ferric carboxymaltose in iron deficiency anemia management in haemodialysis patients with chronic kidney disease. International Journal of Clinical Trials, 12(2), 80–86. https://doi.org/10.18203/2349-3259.ijct20251203

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Original Research Articles