Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status
Abstract Background Intravenous iron replacement is recommended for iron-deficient patients with inflammatory bowel disease (IBD), but may be associated with hypophosphataemia, predisposing to osteomalacia and fractures. This study aimed to evaluate the incidence and risk factors for hypophosphataem...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01298-9 |
| _version_ | 1818879999181062144 |
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| author | Wendy Fang Rachel Kenny Qurat-ul-Ain Rizvi Lawrence P. McMahon Mayur Garg |
| author_facet | Wendy Fang Rachel Kenny Qurat-ul-Ain Rizvi Lawrence P. McMahon Mayur Garg |
| author_sort | Wendy Fang |
| collection | DOAJ |
| description | Abstract Background Intravenous iron replacement is recommended for iron-deficient patients with inflammatory bowel disease (IBD), but may be associated with hypophosphataemia, predisposing to osteomalacia and fractures. This study aimed to evaluate the incidence and risk factors for hypophosphataemia following intravenous ferric carboxymaltose (FCM) in patients with IBD. Methods This prospective observational study of patients with and without IBD evaluated serum phosphate for 28 days following intravenous FCM, and assessed associations with symptoms, markers of inflammation and vitamin D status. Results Twenty-four patients with IBD (11 with Crohn’s disease [CD], 13 with ulcerative colitis [UC], mean age 45 years [range 19–90], 7 female), and 20 patients without IBD (mean age 56 [22–88] y, 11 female), were included. Overall, serum phosphate declined by a mean of 36% at Day 7, with a mean fall of 42% (SD 19%) at some time point over 28 days (p < 0.001). Twenty-four of 44 (55%) patients developed moderate to severe hypophosphataemia (serum phosphate < 0.6 mmol/L). No differences between patients with and without IBD were seen, but patients with CD had greater decline in phosphate than those with UC. There was no association between hypophosphataemia and symptomatic adverse events, faecal calprotectin, C-reactive protein, albumin, platelet count, 25(OH) vitamin D, or 1,25(di-OH) vitamin D. Serum phosphate < 1.05 mmol/L on Day 2 predicted susceptibility to moderate-severe hypophosphataemia (OR 7.0). Conclusions Hypophosphataemia following FCM is common, unrelated to symptomatic adverse events, baseline intestinal or systemic inflammation, or vitamin D status. |
| first_indexed | 2024-12-19T14:38:59Z |
| format | Article |
| id | doaj.art-792030cf28ec4dd2b0b4005835a5df1e |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-19T14:38:59Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-792030cf28ec4dd2b0b4005835a5df1e2022-12-21T20:17:08ZengBMCBMC Gastroenterology1471-230X2020-06-012011910.1186/s12876-020-01298-9Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D statusWendy Fang0Rachel Kenny1Qurat-ul-Ain Rizvi2Lawrence P. McMahon3Mayur Garg4Department of Gastroenterology, Northern HealthEastern Health Clinical School, Monash UniversityDepartment of Gastroenterology, Northern HealthEastern Health Clinical School, Monash UniversityDepartment of Gastroenterology, Northern HealthAbstract Background Intravenous iron replacement is recommended for iron-deficient patients with inflammatory bowel disease (IBD), but may be associated with hypophosphataemia, predisposing to osteomalacia and fractures. This study aimed to evaluate the incidence and risk factors for hypophosphataemia following intravenous ferric carboxymaltose (FCM) in patients with IBD. Methods This prospective observational study of patients with and without IBD evaluated serum phosphate for 28 days following intravenous FCM, and assessed associations with symptoms, markers of inflammation and vitamin D status. Results Twenty-four patients with IBD (11 with Crohn’s disease [CD], 13 with ulcerative colitis [UC], mean age 45 years [range 19–90], 7 female), and 20 patients without IBD (mean age 56 [22–88] y, 11 female), were included. Overall, serum phosphate declined by a mean of 36% at Day 7, with a mean fall of 42% (SD 19%) at some time point over 28 days (p < 0.001). Twenty-four of 44 (55%) patients developed moderate to severe hypophosphataemia (serum phosphate < 0.6 mmol/L). No differences between patients with and without IBD were seen, but patients with CD had greater decline in phosphate than those with UC. There was no association between hypophosphataemia and symptomatic adverse events, faecal calprotectin, C-reactive protein, albumin, platelet count, 25(OH) vitamin D, or 1,25(di-OH) vitamin D. Serum phosphate < 1.05 mmol/L on Day 2 predicted susceptibility to moderate-severe hypophosphataemia (OR 7.0). Conclusions Hypophosphataemia following FCM is common, unrelated to symptomatic adverse events, baseline intestinal or systemic inflammation, or vitamin D status.http://link.springer.com/article/10.1186/s12876-020-01298-9Iron deficiencyFerric carboxymaltoseInflammatory bowel diseaseHypophosphataemiaVitamin D |
| spellingShingle | Wendy Fang Rachel Kenny Qurat-ul-Ain Rizvi Lawrence P. McMahon Mayur Garg Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status BMC Gastroenterology Iron deficiency Ferric carboxymaltose Inflammatory bowel disease Hypophosphataemia Vitamin D |
| title | Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status |
| title_full | Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status |
| title_fullStr | Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status |
| title_full_unstemmed | Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status |
| title_short | Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status |
| title_sort | hypophosphataemia after ferric carboxymaltose is unrelated to symptoms intestinal inflammation or vitamin d status |
| topic | Iron deficiency Ferric carboxymaltose Inflammatory bowel disease Hypophosphataemia Vitamin D |
| url | http://link.springer.com/article/10.1186/s12876-020-01298-9 |
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