Drug Utilization and Safety Profile of Intravenous Iron Isomaltoside 1000 in Cancer Patients With Iron Deficiency Anemia: A Retrospective Study.

BACKGROUND

Iron deficiency anemia (IDA) is a persistent complication in cancer patients and may result from chronic inflammation, poor nutritional intake, and myelosuppressive therapies. Intravenous (IV) iron preparations, such as iron isomaltoside 1000, allow rapid iron repletion. This study evaluated the drug utilization patterns and safety profile of IV iron isomaltoside 1000 in cancer patients with IDA in a real-world setting.

METHODS

This retrospective observational study included 100 adult cancer patients diagnosed with IDA who received IV iron isomaltoside 1000 at two participating centers between January 2024 and September 2025. Demographic data, laboratory parameters (hemoglobin, serum ferritin, total iron-binding capacity (TIBC), and transferrin saturation (TSAT)), dosing details, and adverse events (AEs) were recorded. Continuous variables were expressed as mean ± standard deviation (SD), and paired t-tests were used to compare pre- and post-treatment laboratory values. A p-value less than 0.05 was considered statistically significant.

RESULTS

The mean age of patients was 49.5 ± 17.9 years, and 51% were female individuals. The mean baseline hemoglobin was 8.8 ± 1.9 g/dL and improved to 11.68 g/dL (p < 0.001) after one month of treatment. Among the 92 patients with paired baseline and one-month follow-up data, serum ferritin increased from 10.24 ng/mL to 133.16 ng/mL and TSAT improved from 13.28% to 21.98% (p < 0.001), while TIBC decreased from 441.62 µg/dL to 278.00 µg/dL (p < 0.001). AEs occurred in 7% of patients, including Fishbane reaction in 6% and mild musculoskeletal pain in 1%; all were mild and self-limiting.

CONCLUSION

IV iron isomaltoside 1000 was associated with significant improvement in hematologic parameters and demonstrated a favorable safety profile in cancer patients with IDA. It can be considered a safe and practical option for rapid iron repletion in cancer management.