Infusion Reactions with Alternative Therapies During the National Shortage of Iron Dextran
Recommended Citation
Jacob B, Jamil M, Raslan S, Springer K, Nasser Z, and Kuriakose P. Infusion Reactions With Alternative Therapies During the National Shortage of Iron Dextran. Eur J Haematol 2024.
Document Type
Article
Publication Date
1-1-2025
Publication Title
European journal of haematology
Abstract
Prior to the national shortage of iron dextran in early 2023, it was the most commonly administered intravenous iron infusion at our institution. After the shortage impacted the health system, alternatives such as iron sucrose and sodium ferric gluconate/sucrose were required that utilized lower doses given at more frequent patient visits. Coinciding with their more prevalent use, an increase in iron infusion reactions was observed. Our study analyzed 880 patients who received iron infusions in three Henry Ford Hospital clinics in metropolitan Detroit, Michigan, from July 2022-June 2023. The 74 reactions that occurred were most commonly associated with iron sucrose at the 500 mg dose (41/74, 55.41%, p < 0.0001). Most reactions observed across all iron formulations and doses were mild, with 83.7% being Grade 0 or 1 as defined by the United States Drug Allergy Registry (USDAR) grading scale for immediate reactions. Patients who experienced an infusion reaction were less likely to complete their infusion plans (OR 0.004 for iron dextran, OR 0.128 for iron sucrose, p < 0.0001), with infusions most commonly being completely discontinued thereafter, with a minority pursuing alternative options. More patients with lower number of doses scheduled for iron dextran completed their infusion schedules than those with more doses, but the opposite was seen for iron sucrose. We assessed the impact of the national shortage of iron dextran examining infusion reactions with various iron infusions and doses.
Medical Subject Headings
Humans; Iron-Dextran Complex; Male; Female; Infusions, Intravenous; Middle Aged; Adult; Aged; Anemia, Iron-Deficiency; Hematinics; United States; Ferric Oxide, Saccharated
PubMed ID
39385426
ePublication
ePub ahead of print
Volume
114
Issue
1
First Page
147
Last Page
154
