Retrospective review of effectiveness and safety of intravenous ferric carboxymaltose given to children with iron deficiency anaemia in one UK tertiary centre

Tan MLN1,2, Windscheif PM3, Thornton G3, Gaynor E3, Rodrigues A3, Howarth L3. Eur J Pediatr. 2017 Oct;176(10):1419-1423. doi: 10.1007/s00431-017-2995-8. Epub 2017 Aug 26.

Author information

1 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. michelle_ln_tan@nuhs.edu.sg.

2 Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Paediatrics 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore. michelle_ln_tan@nuhs.edu.sg.

3 Department of Paediatric Gastroenterology, Oxford University Hospitals Trust, Oxford, UK.


In the paediatric population, ferric carboxymaltose (FCM) is only licenced for use in children older than 14 years, and the data in younger children remains scarce. We retrospectively reviewed data of all paediatric patients less than 14 years old who had received FCM infusion from August 2011 to June 2015 at the John Radcliffe Hospital (Oxford University Hospitals), UK. The patient demographics, significant medical history, FCM dose, and blood investigations (pre-FCM and post-FCM) were reviewed. Of the 51 children, 41 had inflammatory bowel disease. There were 24 girls and 27 boys, aged 1 to 13 years, mean (SD) weight 28.4 (13.6) kg. Fifteen patients received at least one more course of FCM up to 35 months later. The time interval between pre-FCM and post-FCM investigations was 1 to 8 months. An improved, median (range) rise in blood indices following one FCM infusion was haemoglobin 2.7 (- 2.4 to 7) g/dL, serum iron 6.6 (- 0.6 to 21.1) μmol/L, and transferrin saturation 14 (- 14 to 38)%. No adverse outcomes were documented.

CONCLUSIONS: FCM was effective in increasing the key blood indices with no adverse outcomes in children less than 14 years of age, with a range of different conditions, majority with gastrointestinal disorders such as IBD. What is Known: • Ferric carboxymaltose (FCM) given via the intravenous (IV) route has been used widely in adults for the treatment of iron deficiency anaemia. • Sparse data exists on FCM use in paediatric population, including young children What is New: • FCM infusion should be considered as a means of iron administration in the paediatric population less than 14 years of age • No adverse outcomes were recorded following FCM in a young paediatric population (less than 14 years of age); the majority of whom had gastrointestinal disorders.

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