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THURSDAY, Nov. 1, 2018 (HealthDay News) — For patients undergoing maintenance hemodialysis, a high-dose intravenous iron regimen administered proactively is noninferior to a low-dose intravenous iron regimen administered reactively, according to a study published online Oct. 26 in the New England Journal of Medicine<\/i> to coincide with a presentation at the American Society of Nephrology’s Kidney Week, held Oct. 23 to 28 in San Diego.<\/p>\n
Iain C. Macdougall, M.D., from King’s College Hospital in the United Kingdom, and colleagues randomly assigned adults undergoing maintenance hemodialysis to receive high-dose iron sucrose, administered intravenously in a proactive manner, or low-dose iron sucrose, administered intravenously in a reactive manner. Overall, 2,141 patients were randomly assigned: 1,093 and 1,048 to the high- and low-dose groups, respectively.<\/p>\n
The researchers found that patients received a median monthly iron dose of 264 and 145 mg in the high- and low-dose groups, respectively. The median monthly dose of an erythropoiesis-stimulating agent was 29,757 and 38,805 IU in the high- and low-dose groups, respectively. Overall, 30.5 percent of patients in the high-dose group and 32.7 percent of patients in the low-dose group had a primary end-point event (nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, or death; hazard ratio, 0.88; 95 percent confidence interval, 0.76 to 1.03; P < 0.001 for noninferiority).<\/p>\n
“Given the absence of harm that was observed with the high-dose intravenous iron regimen in our trial, the safety and efficacy of even higher doses of iron might be explored in further trials,” the authors write.<\/p>\n
Several authors disclosed ties to pharmaceutical companies, including Vifor Pharma, which partially funded the study.<\/p>\n
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