Presenter Status
Fellow
Abstract Type
Research
Primary Mentor
Davis G. Ingram
Start Date
14-5-2024 12:15 PM
End Date
14-5-2024 12:30 PM
Presentation Type
Oral Presentation-Restricted Access
Description
Introduction: Intravenous (IV) ferric carboxymaltose (FCM) and iron sucrose have previously been reported as effective therapies for sleep-related movement disorders (SRMDs) in children. While FCM has a more robust ability to optimize iron stores, iron sucrose is sometimes required instead due to insurance coverage. In this study, we compared clinical and laboratory outcomes of children in our center who underwent either FCM or iron sucrose infusion for SRMDs.
Methods: This was a retrospective study of all children who underwent either IV FCM or iron sucrose infusion in our outpatient infusion center between 1/2023 and 12/2023. While FCM was initially requested for all children, iron sucrose was ordered instead if dictated by insurance coverage. Children were included if the infusion was ordered by a pediatric sleep physician for treatment of confirmed SRMD, there were baseline and follow-up ferritin results available, and there was follow-up clinical information regarding sleep symptoms.
Results: Overall, there were n=40 iron infusions (n=18 FCM and n=22 iron sucrose) that had follow-up clinical and laboratory data available for analysis. There were no significant differences in weight, age, sex, or baseline ferritin level between groups. Children who underwent FCM infusion had significantly higher follow-up ferritin levels compared with iron sucrose (117.9 +/-52.1 vs 69.7+/-38.8 ng/mL, p=0.002) despite longer time to follow-up lab draw (71.3+/- 40.5 vs 28.1+/-37.1 days, p=0.010). Clinical improvement in sleep was noted in children underwent FCM and iron sucrose (72.2% vs 63.6%, p=0.564). Repeated infusions were needed significantly more often with iron sucrose compared with FCM (27.3% vs 0.0%, p=0.024). Each group had 1 case of mild gastrointestinal symptoms during infusion, otherwise no significant infusion reactions were noted. There were no cases of significant hypophosphatemia noted following FCM infusion (mean=4.4+/-0.7, none < 2.0 mg/dL).
Conclusion: Intravenous iron therapy is a safe and effective treatment modality for pediatric SRMDs. FCM is superior to iron sucrose both in terms of improvement in ferritin level as well as decreased need for repeated infusions.
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Ferric Carboxymaltose versus Iron Sucrose for Pediatric Sleep-related Movement Disorders
Introduction: Intravenous (IV) ferric carboxymaltose (FCM) and iron sucrose have previously been reported as effective therapies for sleep-related movement disorders (SRMDs) in children. While FCM has a more robust ability to optimize iron stores, iron sucrose is sometimes required instead due to insurance coverage. In this study, we compared clinical and laboratory outcomes of children in our center who underwent either FCM or iron sucrose infusion for SRMDs.
Methods: This was a retrospective study of all children who underwent either IV FCM or iron sucrose infusion in our outpatient infusion center between 1/2023 and 12/2023. While FCM was initially requested for all children, iron sucrose was ordered instead if dictated by insurance coverage. Children were included if the infusion was ordered by a pediatric sleep physician for treatment of confirmed SRMD, there were baseline and follow-up ferritin results available, and there was follow-up clinical information regarding sleep symptoms.
Results: Overall, there were n=40 iron infusions (n=18 FCM and n=22 iron sucrose) that had follow-up clinical and laboratory data available for analysis. There were no significant differences in weight, age, sex, or baseline ferritin level between groups. Children who underwent FCM infusion had significantly higher follow-up ferritin levels compared with iron sucrose (117.9 +/-52.1 vs 69.7+/-38.8 ng/mL, p=0.002) despite longer time to follow-up lab draw (71.3+/- 40.5 vs 28.1+/-37.1 days, p=0.010). Clinical improvement in sleep was noted in children underwent FCM and iron sucrose (72.2% vs 63.6%, p=0.564). Repeated infusions were needed significantly more often with iron sucrose compared with FCM (27.3% vs 0.0%, p=0.024). Each group had 1 case of mild gastrointestinal symptoms during infusion, otherwise no significant infusion reactions were noted. There were no cases of significant hypophosphatemia noted following FCM infusion (mean=4.4+/-0.7, none < 2.0 mg/dL).
Conclusion: Intravenous iron therapy is a safe and effective treatment modality for pediatric SRMDs. FCM is superior to iron sucrose both in terms of improvement in ferritin level as well as decreased need for repeated infusions.
