The use of ferric carboxymaltose infusions on the same day as endoscopy in the management of iron-deficiency anemia.

Background and Aim: Iron-deficiency anemia is one of the most prevalent medical conditions in Australia. In addition to iron supplementation, endoscopic evaluation is standard of care for all patients with iron-deficiency anemia without a clear underlying cause. We aimed to evaluate the safety, efficacy, and cost-benefit of ferric carboxymaltose (FCM) infusions on the same day as endoscopic evaluation. Method(s): We conducted a retrospective audit of all patient files for patients who received FCM infusions across a major tertiary referral center and a large private endoscopy day hospital from 1 January 2015 to 31 December 2016. We analyzed the data in two groups: an intervention group who received FCM infusions and endoscopy on the same day and a control group who underwent endoscopy on the same day as the intervention group but who did not receive FCM infusions on that day. Outcomes measured included biochemical parameters at entry and at 6 weeks, adverse events, and time in the endoscopy unit. The groups were matched for date, procedure, and sex. Result(s): We identified a total of 313 patients who received same-day endoscopy and FCM infusion. We evaluated 95 of these patients: 34 in the intervention group and 61 controls. Baseline characteristics (Table 1) were similar in the two groups. There were five adverse events in each group; however, in the intervention group, only one of these occurred following the FCM infusion. Same-day infusions increased time in endoscopy (191.6 vs 154.7 min; P = 0.01). All biochemical indices significantly improved in the intervention group (Table 2). Cost data were available for 14 intervention and 27 control patients (Table 3). Same-day FCM infusions resulted in an average cost-benefit of $229.70 per patient when compared with separate admissions for endoscopy and hospital-in-the-home for the FCM infusion. Conclusion(s): This novel study highlights that FCM infusions on the day of endoscopy appear to be safe and effective for pat