Ferric carboxymaltose improves Hb levels in patients with iron deficiency anemia: Study

A new study published in the Turkish Journal of Hematology showed that ferric carboxymaltose may raise hemoglobin and ferritin levels in patients with underlying iron deficiency anemia (IDA) when compared to iron sucrose.

A common condition with serious health effects, IDA affects a number of patient demographics, such as those with gastrointestinal issues, severe menstrual bleeding, and chronic illnesses. When quick iron replenishment is required if oral iron formulations are inefficient or poorly tolerated, intravenous (IV) iron treatment is frequently chosen. Iron sucrose (IS) and ferric carboxymaltose (FCM) are commonly used intravenous iron treatments. When compared to IS, FCM enables higher dosages in fewer administrations, which is more practical for both patients and medical professionals.

Controlled iron release is made possible by the combination of FCM, a colloidal iron (III) hydroxide, with carboxymaltose, a carbohydrate polymer. This makes it possible to restore the iron reserves needed for the production of myoglobin, hemoglobin, and other enzyme systems involved in cellular metabolism and oxygen transport.

FCM lowers the risk of oxidative stress by facilitating iron absorption through the reticuloendothelial system without releasing free iron, in contrast to formulations based on dextran. Thus, to thoroughly examine the safety, effectiveness, and tolerance of two widely used IV iron preparations (ferric carboxymaltose and iron sucrose) in adult patients with iron-deficiency anemia, Lokman Tanrıverdi and team carried out this study.

A comprehensive literature search was carried out via PubMed, Web of Science, Ovid Medline, Scopus, and the Cochrane Library until January 1, 2024 to find randomized controlled trials that directly compare FCM and IS therapies in adult patients with IDA. Changes in hemoglobin levels during follow-up were the main result. 

There were 14 studies included with a total of 4757 people in all. Hemoglobin and ferritin levels increased nonsignificantly with FCM in comparison to IS. While there was no significant difference in serious adverse events, FCM had a greater risk of hypophosphatemia which was non-significant and was linked to a higher risk of hypersensitive responses than IS.

Overall, the results of this systematic review and meta-analysis found FCM to be more effective than IS at raising hemoglobin and ferritin levels, especially in patients with gynecological conditions that underlie iron deficiency anemia.

Reference:

Tanrıverdi, L. H., & Sarıcı, A. (2025). Efficacy, safety, and tolerability of ferric carboxymaltose and iron sucrose in iron deficiency anemia: A systematic review and meta-analysis of randomized controlled trials. Turkish Journal of Hematology. https://doi.org/10.4274/tjh.galenos.2025.2025.0034