Conventional oral iron supplements tend to worsen gastrointestinal symptoms in patients with inflammatory bowel disease. Feraccru, a new oral iron product with an improved gastrointestinal tolerability profile, may be useful as an alternative to intravenous iron in these patients.
The iron in Feraccru is in a stable state as a complex with a ligand. The complex provides controlled release of iron for uptake across the intestinal wall and transfer to the iron transport and storage proteins (transferrin and ferritin). On uptake from the gastrointestinal tract, the complex dissociates, leaving the iron alone to enter the systemic circulation.
Feraccru is given at a dose of one capsule twice daily, taken on an empty stomach. Treatment is normally continued for at least 12 weeks depending on severity.
No impact on bowel disease
The safety and tolerability of ferric maltol were assessed in a placebo-controlled trial involving 128 patients with ulcerative colitis or Crohn's disease (quiescent or mild to moderate) who had previously failed treatment with oral iron. Patients were randomised to receive either ferric maltol or placebo twice daily for 12 weeks.
At week 12, patients in the ferric maltol group showed a significant increase in haemoglobin concentration compared with those in the placebo group (mean 2.25g/dL, p<0.0001)
Ferric maltol had no impact on the severity of inflammatory bowel disease, with a safety profile comparable to placebo. The most frequent adverse effects in both groups were abdominal pain, diarrhoea and constipation.