Summary

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• This summary is based on the review of 23 systematic review(s)/meta-analysis(es). ^[1-23]
• Hemoglobin Increase: FCM (ferric carboxymaltose) was probably superior to IS in increasing hemoglobin levels (RR (relative risk) 1.25, 95% CI (confidence interval) 1.06 to 1.46, NNTB = 9). In pregnant women, FCM showed a significant increase in hemoglobin compared to IS/polymaltose (SMD (standardized mean difference) 0.89 g/dL, 95% CI 0.27 to 1.51).
• Serum Ferritin Levels in Pregnancy: FCM significantly increased serum ferritin levels compared to IS/polymaltose in pregnant women (SMD 22.53 µg/L, -7.26 to 52.33).
• RBC Utilization Preoperatively: IV iron monotherapy did not notably reduce RBC utilization, but combining iron with ESAs (Erythropoiesis-stimulating agents) likely reduced the number of RBC units transfused (moderate-certainty evidence).
• Resolution of IDA in IBD: FCM probably led to higher IDA resolution rates in IBD patients compared to IS (150/244 vs. 118/239, RR 1.25, 95% CI 1.06 to 1.46).
• Hypophosphatemia prevalence associated with FCM ranged from 0.0% to 92.1%, with clinical consequences including severe fatigue, osteomalacia, and bone deformities observed in patients with acute and chronic hypophosphatemia.
• FCM was linked to fewer adverse events than IS in the general population, including pregnant women and heart failure patients, with HF patients on FCM showing a lower incidence of hypophosphatemia-related adverse events compared to those on placebo.
• No serious adverse events were reported for FCM or other IV iron formulations across various studies, including those involving pregnant women and other subgroups.
• Ferric carboxymaltose (FCM) demonstrated increased effectiveness and a favorable safety profile in specific subgroups, including pregnant women (higher efficacy and fewer adverse events than iron sucrose), heart failure patients (reduced HF-related and cardiovascular hospitalizations without increased mortality), and patients with inflammatory bowel disease (more effective resolution of iron deficiency anemia compared to iron sucrose).