Ferric Derisomaltose Versus Iron Sucrose in Pregnancy (FLIP): A Retrospective Observational Study on Outpatient Intravenous Iron Infusion Capacity.

OBJECTIVES

To assess the impact of introducing a total dose infusion iron such as ferric derisomaltose (FD) on obstetric infusion clinic capacity.

METHODS

This retrospective study analyzed pregnant patients ≥18 years old treated with intravenous (IV) iron from June 2021 to February 2024. The primary outcome measured the number of unique outpatients treated with IV iron (iron sucrose [IS] or FD) per month in the obstetrics infusion clinic during baseline period 1 (June 2021-May 2022), period 2 when FD was available (June 2022-July 2023), and period 3 when our institutional policy was updated to include FD in pregnancy (August 2023-February 2024). IS and FD were compared for the following: total infusion time per pregnancy, mean number of visits per pregnancy, treatment completion rate, and adverse reactions. Descriptive analyses were conducted, with P < 0.05 considered significant.

RESULTS

Of 514 patients, 327 received IS and 187 FD. Introduction of FD increased the mean number (± SD) of patients treated per month with IV iron from 20.1 ± 4.5 in period 1 to 20.9 ± 4.4 in period 2 to 30.7 ± 6.3 in period 3 (P < 0.0001: periods 1 and 2 vs. Period 3). Compared to IS, those treated with FD had shorter total infusion times (252 ± 92 vs. 65 ± 10 minutes; P < 0.0001), fewer clinic visits (1.0 ± 0.1 vs. 2.2 ± 0.8; P < 0.0001), and higher treatment completion rates (99% vs. 83%), with no increase in adverse reactions (7.1% IS, 5.4% FD).

CONCLUSIONS

Introducing a total dose infusion iron improved clinic capacity, increased access to care, and enhanced efficiency through patient-important outcomes such as infusion time and number of visits for iron.