Implementing total-dose ferumoxytol in lieu of split-dose ferumoxytol.

Background: Ferumoxytol is Food and Drug Administration-approved as two 510 mg infusions. Retrospective and prospective reviews have established that a single 1020 mg infusion is as efficacious and safe as two 510 mg infusions.

Objectives: To transition our preferred intravenous iron infusion practice from two 510 mg infusions to a single 1020 mg ferumoxytol infusion.

Practice Description: This is a prospective process improvement study conducted at Tripler Army Medical Center, a large academic medical center.

Practice Innovation: We set up an evidence-based project to transition and monitor our preferred iron treatment of ferumoxytol from 2 doses to 1 dose.

Evaluation Methods: We collected efficacy and safety data for 188 unique patients receiving 228 infusions, of which 62 were single 1020 mg doses, and 166 were two 510 mg doses.

Results: Comparing the 1020 mg dose in 62 patients with 166 patients treated with two 510 mg infusions, we found no increase in the rate of infusion reactions (4.8 % vs. 4.8 %) and comparable improvement in ferritin and hemoglobin (144 ng/mL vs. 140 ng/mL; P value = 0.874, and 1.8 g/dL vs. 1.9 g/dL; P value = 0.721, respectively).

Conclusion: Thus, we were able to successfully transition to total-dose ferumoxytol for iron-deficient anemia, effectively reducing patient treatment visits without any difference in safety or efficacy. Ferumoxytol 1020 mg infused intravenously over 30 minutes in 250 mL normal saline single dose is a viable, safe, and effective treatment for iron-deficiency anemia.