International Liver Congress

International Liver Congress

Source:

Tsiakas I, et al. Abstract LBO-2765. Presented at: the International Liver Congress; June 23-26 (virtual meeting).

Disclosures: Tsiakas reports no relevant financial disclosures.
July 02, 2021
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Ferric carboxymaltose corrects iron deficiency anemia in advanced cirrhosis

Source:

Tsiakas I, et al. Abstract LBO-2765. Presented at: the International Liver Congress; June 23-26 (virtual meeting).

Disclosures: Tsiakas reports no relevant financial disclosures.
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Intravenous ferric carboxymaltose corrected iron deficiency anemia among patients with advanced cirrhosis, according to a late breaking presentation at the International Liver Congress.

“Iron deficiency anemia (IDA) commonly occurs in up to 40% of patients with cirrhosis due to chronic blood loss from gastroesophageal varices and portal gastropathy. Previous studies have suggested anemia in cirrhosis associated with higher occurrence of hepatic decompensation and mortality,” Ilias Tsiakas, University of Ioannina, Ioannina, Greece, said. “The optimal treatment of IDA in advanced cirrhosis is unknown; consequently, no data exists on the effects of ferric carboxymaltose (FCM) in patients with advanced cirrhosis and IDA.”

To assess the effectiveness of intravenous FCM vs. oral ferrum sulfate to increase hemoglobin levels, researchers analyzed 90 patients with cirrhosis and anemia further stratified by an IDA diagnosis (group 1; n = 45) vs. no IDA diagnosis (group 2; n = 45). Patients in group 1 received either FCM or ferrum sulfate for 3 months followed by FCM treatment to all patients when indicated; patients in group 2 received blood transfusions. Within group 1, researchers measured hemoglobin levels, systemic hemodynamics, neurohumoral factors and renal function at baselines and 3 months. Overall measured endpoints included liver stiffness assessment every 6 months as well as 2-year survival.

According to study results, liver stiffness remained unchanged in both groups while FCM induced increases in hemoglobin (12.1 g/dL vs. 9.5 g/dL), mean arterial pressure (83.8 mmHg vs. 81.3 mmHg), systemic vascular resistance (1439 dyn.sec.cm-5 vs. 1266 dyn.sec.cm-5) glomerular filtration rate (87.3 mL/min vs. 76.7 mL/min) and sodium/potassium ratio (1.7 vs. 1.4). FCM induced decreases in plasma renin activity (39.8 pg/mL vs. 83.8 pg/mL) and serum noradrenalin (55.2 pg/mL vs. 100.6 pg/mL). Compared with patients in group 2, patients in group 1 had higher 2-year survival (88% vs. 67.3%).

“IDA in patients with advanced cirrhosis can be corrected with FCM but not with oral iron,” Tsiakas concluded. “FCM treatment is safe and improves systemic hemodynamics, renal function and prognosis in advanced cirrhosis with ascites.”