Intravenous ferric derisomaltose versus saccharated ferric oxide for iron deficiency anemia associated with menorrhagia: a randomized, open-label, active-controlled, noninferiority study

Int J Hematol. 2022 Nov;116(5):647-658. doi: 10.1007/s12185-022-03401-0. Epub 2022 Jul 6.

Abstract

A multicenter, randomized, open-label, phase III study was conducted to compare the efficacy and safety of intravenous ferric derisomaltose (FDI) versus saccharated ferric oxide (SFO) in Japanese patients with iron deficiency anemia associated with menorrhagia. FDI can be administered as a single dose up to 1000 mg, whereas SFO has a maximum single dose of 120 mg. The primary endpoint, which was the maximum change in hemoglobin concentration from baseline, was noninferior for the FDI group compared with the SFO group. The incidence of treatment-emergent adverse events was lower in the FDI group (66.2%) than in the SFO group (90.8%). Notably, the incidence of serum phosphorus level < 2.0 mg/dL was significantly lower in the FDI group (8.4%) than in the SFO group (83.2%), and severe hypophosphatemia (≤ 1.0 mg/dL) occurred in 6.7% of SFO‑treated patients compared with none in the FDI group. The percentage of patients who achieved the cumulative total iron dose during the 8-week treatment period was higher in the FDI group (92.8%) than in the SFO group (43.2%). The study met its primary endpoint, and also demonstrated the tolerability of a high dose of FDI per infusion, with a lower incidence of hypophosphatemia.

Keywords: Ferric derisomaltose; Hypophosphatemia; Intravenous iron preparation; Iron deficiency anemia.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Anemia, Iron-Deficiency* / drug therapy
  • Anemia, Iron-Deficiency* / etiology
  • Female
  • Ferric Compounds* / therapeutic use
  • Ferric Oxide, Saccharated / adverse effects
  • Hemoglobins / analysis
  • Humans
  • Hypophosphatemia* / chemically induced
  • Iron
  • Iron Deficiencies*
  • Menorrhagia* / complications
  • Menorrhagia* / drug therapy
  • Phosphorus / blood

Substances

  • Ferric Compounds
  • ferric derisomaltose
  • Ferric Oxide, Saccharated
  • Hemoglobins
  • Iron
  • Phosphorus