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Ferumoxytol: a silver lining in the treatment of anemia of chronic kidney disease or another dark cloud?

Authors Barton Pai A, Garba

Received 18 July 2012

Accepted for publication 9 August 2012

Published 29 August 2012 Volume 2012:3 Pages 77—85

DOI https://doi.org/10.2147/JBM.S29204

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Amy Barton Pai, Adinoyi O Garba

Albany College of Pharmacy and Health Sciences, Albany, New York, NY, USA

Abstract: Intravenous iron therapy is pivotal in the treatment of anemia of chronic kidney disease to optimize the response of hemoglobin to erythropoiesis-stimulating agents. Intravenous iron use in patients with chronic kidney disease is on the rise. Recent clinical trial data prompting safety concerns regarding the use of erythropoiesis-stimulating agents has stimulated new US Food and Drug Administration label changes and restrictions for these agents, and has encouraged more aggressive use of intravenous iron. The currently available intravenous iron products differ with regard to the stability of the iron-carbohydrate complex and potential to induce hypersensitivity reactions. Ferumoxytol is a newer large molecular weight intravenous iron formulation that is a colloidal iron oxide nanoparticle suspension coated with polyglucose sorbitol carboxymethyl ether. Ferumoxytol has robust iron-carbohydrate complex stability with minimal dissociation or appearance of free iron in the serum, allowing the drug to be given in relatively large doses with a rapid rate of administration. Clinical trials have demonstrated the superior efficacy of ferumoxytol versus oral iron with minimal adverse effects. However, recent postmarketing data have demonstrated a risk of hypersensitivity that has prompted new changes to the product information mandated by the Food and Drug Administration. Additionally, the long-term safety of this agent has not been evaluated, and its place in the treatment of anemia of chronic kidney disease has not been fully elucidated.

Keywords: iron, ferumoxytol, oxidative stress, safety, kidney disease

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