Efficacy and Safety of IV Monofer in Gynaecological Patients

Abstract Description

Authors (including presenting author) :

Lee LTL (1) Fan HL

Affiliation :

(1) Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital

Introduction :

IV Monofer was introduced to PYNEH Gyn in Dec 2017. It was mainly used for patients with iron deficiency anemia who could not tolerate oral iron or require rapid top up of Hb, the latter of which would usually otherwise receive blood products. The experience of our department with IV Monofer has so far been positive. From both existing literature and the results of our audit, IV Monofer is highly effective and well tolerated for most patients. While some of our patients did suffer from adverse drug events, all were mild and there were no cases of anaphylaxis. With the adoption of IV Monofer, our unit will be able to treat iron deficiency anemia safely and effectively, and reduce our reliance on blood products in the long run.

Objectives :

To evaluate the efficacy and safety of IV Monofer in PYNEH Gyn patients

Methodology :

Retrospective audit for all PYNEH Gyn patients receiving IV Monofer between Dec 2017 and May 2018 (6 month period).

Result & Outcome :

IV Monofer was given in 102 cases in the audit period, and 97 medical records were successfully traced and included. 88/97 (90.7%) of cases had anemia from menorrhagia, and 47/96 (48.9%) had symptomatic anemia. Average Hb before IV Monofer was 6.9g/dL, and baseline iron profile (where checked) showed iron deficiency in 53/60 (88.3%) of patients. IV Monofer was effective and well tolerated. Average Hb response was +4.3g/dL at 38.8 days and 73/76 (96.1%) cases had optimal response of Hb +2g/dL or more. While 11/97 (11.3%) developed adverse events, only 4 of these were immediate and resulted in discontinuation of infusion. The remaining 7 were rashes of delayed-onset of uncertain significance. The use of packed cells / whole blood fell by 40% relative to the same period the previous year. Given the relatively steady caseload and casemix of our department, a significant part of the reduction can likely be attributed to IV Monofer.