What is the role of ferumoxytol injection (Feraheme) 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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Feraheme (ferumoxytol injection), a hematinic, was initially approved by the FDA in 2009 to treat IDA in adults with chronic kidney disease (CKD). Ferumoxytol injection consists of a superparamagnetic iron oxide that is coated with a carbohydrate shell, which helps isolate the bioactive iron from plasma components until the iron-carbohydrate complex enters the reticuloendothelial system macrophages of the liver, spleen, and bone. The released iron then either enters the intracellular storage iron pool (eg, ferritin) or is transferred to plasma transferrin for transport to erythroid precursor cells for incorporation into hemoglobin. [32]

In January 2018, the FDA expanded use for ferumoxytol injection to include all eligible adults with iron deficiency anemia who have intolerance or unsatisfactory response to oral iron. Expanded approval was based on data from two phase 3 trials comparing ferumoxytol and iron sucrose, as well as data from a phase 3 trial comparing ferumoxytol to ferric carboxymaltose injection. In the phase 3 double-blind safety and efficacy study (n= 609) comparing ferumoxytol to iron sucrose, ferumoxytol treatment-emergent adverse events were mainly mild to moderate. Ferumoxytol was effective and well tolerated in patients with iron deficiency anemia of any underlying cause in whom oral iron was ineffective or could not be used. [33]

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