What is the role of ferric citrate (Auryxia) in the treatment of iron deficiency anemia?

Updated: Sep 07, 2019
  • Author: James L Harper, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Ferric citrate (Auryxia) gained US Food and Drug Administration (FDA) approval in November 2017 for treatment of iron deficiency anemia in adults with chronic kidney disease (CKD) not on dialysis. Each tablet of ferric citrate 1 gram is equivalent to 210 mg of ferric iron. Approval was based on results from a 24-week placebo-controlled phase 3 clinical trial in 234 adults with stage 3-5 non–dialysis-dependent CKD. Trial participants had hemoglobin levels between 9-11.5 g/dL and were intolerant to or had an inadequate response to prior treatment with oral iron supplements. The starting dose in the study was 3 tablets daily with meals; the mean dose was 5 tablets per day. Importantly, during the study, patients were not allowed to receive any intravenous or oral iron, or erythropoiesis-stimulating agents (ESAs). Significant increases in hemoglobin levels of >1 g/dL at any point during the 16-week efficacy period occurred in 52.1% of patients taking ferric citrate compared with 19.1% in the placebo group). [22]

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