Intravenous ferric carboxymaltose for iron deficiency anemia or iron deficiency without anemia after poor response to oral iron treatment: Benefits and risks in a cohort of 144 children and adolescents

Pediatr Blood Cancer. 2020 Oct;67(10):e28614. doi: 10.1002/pbc.28614. Epub 2020 Jul 30.


Objective: The objective of this single-center observational study was to determine the clinical and hematologic responses to intravenous ferric carboxymaltose (FCM) in a cohort of pediatric patients with poor response to oral iron therapy. The occurrence of adverse events was systematically recorded for up to 96 hours after infusion.

Study design: A retrospective cohort of 144 consecutive patients aged 18 months to < 18 years with iron deficiency anemia (IDA) or iron deficiency (ID) without anemia was investigated. All patients had failed oral iron therapy. The assessments before and after FCM treatment followed a predefined protocol.

Results: One hundred of 117 (85 %) of patients with complete data achieved the target ferritin level ≥ 30 µg/L after a single FCM dose. Of 77 patients with IDA and complete data, 38 (49%) showed a complete hematological response within 6-12 weeks; a complete or partial response was achieved by 83%. Clinical symptoms improved in 85% of all patients. In 92% of patients (n = 133 /144), FCM infusion was uneventful. During the 96-hour follow-up, five patients reported potentially related symptoms. No serious adverse events occurred.

Conclusion: The study confirms the safety and efficacy of FCM in children (aged 18 months and older) and adolescents unresponsive to oral therapy, in real-world experience. Single-dose FCM treatment was followed by clinical improvement with advantages of safety, compliance, and lower cost compared with previous generation parenteral iron preparations that had to be administered in fractionated sessions.

Keywords: cohort study; ferric carboxymaltose; hematology nonmalignant; iron deficiency; iron deficiency anemia; pediatric.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Anemia, Iron-Deficiency / drug therapy*
  • Anemia, Iron-Deficiency / pathology
  • Child
  • Child, Preschool
  • Female
  • Ferric Compounds / administration & dosage*
  • Follow-Up Studies
  • Humans
  • Infant
  • Iron Metabolism Disorders / drug therapy*
  • Iron Metabolism Disorders / pathology
  • Male
  • Maltose / administration & dosage
  • Maltose / analogs & derivatives*
  • Prognosis
  • Retrospective Studies


  • Ferric Compounds
  • ferric carboxymaltose
  • Maltose