Dexferrum (iron dextran; Luitpold Pharmaceuticals) is an intravenous (IV) iron maintenance treatment used to help elevate hemoglobin levels in patients with anemia in chronic kidney disease (CKD). The iron is transported via transferrin to erythroid precursor cells. Erythroid precursor cells incorporate the iron into hemoglobin as the cell matures into a red blood cell. Dexferrum, and other iron therapies, are often used in combination with erythropoiesis-stimulating agent (ESA) therapies to increase the number of patients able to achieve target hemoglobin levels compared to patients on ESA therapies alone (Singh, 2008). Dexferrum has a significantly less attractive clinical and commercial profile compared to more recent IV iron therapies, Injectafer (ferric carboxymaltose; Vifor/Luitpold Pharmaceuticals/Zeria), Venofer (poly-nuclear iron (III)-hydroxide in sucrose; Vifor/Luitpold Pharmaceuticals), and Feraheme (ferumoxytol; AMAG Pharmaceuticals), due to increased risk of iron toxicity and a highly inconvenient dosing strategy.
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