Evaluation of Clinical Characteristics and Treatment Appropriateness in Patients Receiving Intravenous Iron Therapy

Intravenous (IV) iron is frequently used to treat iron deficiency. While IV therapy offers several benefits, it also has drawbacks, including high costs, potential allergic reactions, and the need for hospitalization. This study aimed to assess patient- and disease-related factors in IV iron therapy and to re-evaluate treatment appropriateness using an algorithm developed from current guideline recommendations.

This retrospective, single-center study included patients receiving IV iron at a tertiary care hospital between May 2 and October 15, 2023. Threshold values for iron deficiency, based on a review of current guidelines, were defined as ferritin <30 μg/L or, when C-reactive protein (CRP) ≥5 mg/L, ferritin <100 μg/L and transferrin saturation (TSAT) <20%.

A total of 264 patients were re-evaluated. IV iron therapy was deemed inappropriate in 81 patients (31%). The primary reason for inappropriateness in 74 patients (28%) was the lack of preference for oral iron therapy as the first-line option. Inappropriate treatment was significantly more frequent in the group without anemia (p<0.001) and among patients over 65 years old (p=0.03).

Developing treatment algorithms that integrate evidence, patient factors, and clinical experience may help reduce unnecessary costs and improve prescription quality.