Please use this identifier to cite or link to this item: doi:10.22028/D291-39859
Title: Hypophosphatemia after high-dose iron repletion with ferric carboxymaltose and ferric derisomaltose-the randomized controlled HOMe aFers study
Author(s): Emrich, Insa E.
Lizzi, Fabio
Siegel, Jonathan David
Seiler-Mussler, Sarah
Ukena, Christian
Kaddu-Mulindwa, Dominic
D'Amelio, Roberto
Wagenpfeil, Stefan
Brandenburg, Vincent M.
Böhm, Michael
Fliser, Danilo
Heine, Gunnar H.
Language: English
Title: BMC medicine
Volume: 18
Issue: 1
Publisher/Platform: BioMed Central
Year of Publication: 2020
Free key words: Hypophosphatemia
Iron deficiency anemia
Ferric carboxymaltose
Ferric derisomaltose
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Background In patients with iron deficiency anemia, ferric carboxymaltose (FCM) and ferric derisomaltose (FDI) allow high-dose iron repletion. While FCM is reported to induce hypophosphatemia, the frequency of hypophosphatemia after an equivalent dosage of FDI had not been assessed prospectively. Methods In the prospective, single-center, double-blind HOMe aFers study, 26 women with iron deficiency anemia (hemoglobin < 12 g/dL plus either plasma ferritin ≤ 100 ng/mL or a plasma ferritin ≤ 300 ng/mL and transferrin saturation (TSAT) ≤ 30%) were randomized to a single intravenous infusion of 20 mg/kg body weight (up to a maximum of 1000 mg) FCM or FDI. The primary endpoint was the incidence of hypophosphatemia (plasma phosphorus levels < 2.0 mg/dL at day 1, day 7 ± 2, and/or day 35 ± 2 after the infusion). In order to investigate potential skeletal and cardiovascular implications, we assessed changes in other components of mineral and bone metabolism, left ventricular function, and arrhythmias. Results Hypophosphatemia occurred more frequently in women treated with FCM (9 out of 12 [75%]) than in those treated with FDI (1 out of 13 [8%]; p = 0.001). Within 24 h after iron supplementation, women in the FCM group had significant higher plasma intact FGF23 (p < 0.001) and lower plasma 1.25-dihydroxyvitamin D (p < 0.001). As an indicator of urinary phosphorus losses, urinary fractional phosphorus excretion was higher in the FCM group (p = 0.021 at day 7 ± 2 after iron supplementation). We did not observe differences in skeletal and cardiovascular markers, potentially because of the limited number of participants. Conclusions While both FCM and FDI provide efficient iron repletion in participants with iron deficiency anemia, FCM induced hypophosphatemia more often than FDI. Trial registration Clinical NCT02905539. Registered on 8 September 2016. 2015-004808-36 (EudraCT Number) U1111-1176-4563 (WHO Universal Trial Number) DRKS00010766 (Deutsches Register Klinischer Studien)
DOI of the first publication: 10.1186/s12916-020-01643-5
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-398594
ISSN: 1741-7015
Date of registration: 26-May-2023
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Michael Böhm
M - Prof. Dr. Danilo Fliser
M - Prof. Dr. Stefan Wagenpfeil
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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