Iron deficiency anemia: Disease heterogeneity and the rapid evolution of traditional diagnosis and treatment paradigms

Release Date: February 1, 2018

Expiration Date: January 31, 2019

Note: This activity is no longer available for credit

Agenda

Classification and Causes of Iron Deficiency and Iron Deficiency Anemia (duration 14:30)
Maureen M. Achebe, MD, MPH
Clinical Director, Non-Malignant Hematology Clinic
Dana-Farber Cancer Institute
Assistant Professor of Medicine
Harvard Medical School
Boston, MA

Diagnostic Approaches to Iron Deficiency Anemia:
Conventional Tests or Newer Assessments? (duration 13:00)
Thomas DeLoughery, MD, MACP
Professor of Medicine
OHSU School of Medicine
Portland, OR

Treatment: From Oral Iron Supplementation to Intravenous Therapy
(duration 21:00)
Michael Auerbach, MD, FACP
Clinical Professor of Medicine
Georgetown University School of Medicine
Washington, DC

Provided by:

Original activity supported by an educational grant from: Luitpold Pharmaceuticals, Inc.

Learning Objectives

After completing the activity, clinicians will be better able to:

• Describe iron metabolism and the mechanism of iron deficiency and iron deficiency anemia
• Differentiate the causes of iron deficiency and iron deficiency anemia and confounding factors
• Evaluate the different approaches to diagnose iron deficiency and iron deficiency anemia
• Discuss the indications for intravenous iron therapy, the various formulations, and the benefits and risk of each

Target Audience

Hematologists, oncologists, and allied healthcare professionals who manage patients with iron deficiency anemia

Statement of Need

Iron deficiency (ID) and iron deficiency anemia (IDA) are common conditions worldwide, with 1.6 billion people in both developing and developed countries affected by these conditions, which can have serious consequences. Clinicians can readily diagnose ID and IDA in a healthy individual with a single cause of anemia. However, “explosive knowledge” of iron metabolism over the last 20 years has made it increasingly more difficult for them to determine the correct diagnosis and treatment [Camaschella, Blood Rev 2017]. This leaves clinicians uncertain as to the appropriate tests to order, how to interpret the results, what treatment to use, and at what dose. This activity is designed to clarify these issues and help the healthcare team provide optimal care for patients.

Disclosures

Maureen Achebe, MD (Presenter)
Consulting fees: Luitpold Pharmaceuticals, Inc., AMAG Pharmaceuticals, Inc., Syros Pharmaceuticals, Inc.

Michael Auerbach, MD (Course Director and Presenter)
Consulting fee: AMAG Pharmaceuticals, Inc., American Regent Luitpold, Pharmacosmos
Contracted research (Data management only): AMAG Pharmaceuticals, Pharmacosmos

Thomas DeLoughery, MD (Presenter)
No relevant financial relationships with a commercial interest.

Permissions

 Maureen Achebe presentation

• Slide 14: Functional Iron Deficiency

Republished with permission of the American Society of Hematology, from Bruganara C, et al. Red blood cell regeneration induced by subcutaneous recombinant erythropoietin: iron-deficient erythropoiesis in iron-replete subjects. Blood 1993; 81(4):956-64; permission conveyed through Copyright Clearance Center, Inc.

• Slide 22: Prevalence of Anemia by Cr and GFR in a Pre-dialysis Population

McClellan W, et al. The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin 2004;20(9):1501-10, reprinted by permission of the publisher (Taylor & Francis Ltd, http://www.tandfonline.com)

Michael Auerbach presentation

• Slide 9: Once vs Twice Daily Dosing

Reprinted from Lancet Haematol, Vol 4, No 11, Stoffel NU, Cercamondi CI, Brittenham G, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials, e524-e533, © 2017, with permission from Elsevier.

• Slide 22: Iron Deficiency in Infancy Alters Neural Correlates of Recognition Memory at 10 Years: Key Study Results

Reprinted from J Pediatr, Vol 160, Congdon EL, Westerlund A, Algarin CR, et al. Iron deficiency in infancy is associated with altered neural correlates of recognition memory at 10 years, pp 1027-1033, © 2012, with permission from Elsevier.

Thomas DeLoughery presentation

• Slide 12: [No title]

From N Engl J Med, Lipschitz DA, Cook, JD, Finch CA, A clinical evaluation of serum ferritin as an index of iron stores, Vol 290, pages 1213-1216, © 1974 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.

• Slide 15: Most Women Have Low Iron Stores

Reproduced with permission from JAMA, 1967, 199(12):897-900. Copyright© 1967 American Medical Association. All rights reserved

• Slide 16: Age and Ferritin

Reprinted from Am Heart J, Vol 140, Zacharski LR, Ornstein, DL, Woloshin S, et al. Association of age, sex, and race with body iron stores in adults: analysis of NHANES III data, pp 98-104, © 2000, with permission from Elsevier.

Disclaimer

The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Hemedicus, the supporter, or Frontline Medical Communications. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

Release Date: February 1, 2018

Expiration Date: January 31, 2019

Note: This activity is no longer available for credit

Agenda

Classification and Causes of Iron Deficiency and Iron Deficiency Anemia (duration 14:30)
Maureen M. Achebe, MD, MPH
Clinical Director, Non-Malignant Hematology Clinic
Dana-Farber Cancer Institute
Assistant Professor of Medicine
Harvard Medical School
Boston, MA

Diagnostic Approaches to Iron Deficiency Anemia:
Conventional Tests or Newer Assessments? (duration 13:00)
Thomas DeLoughery, MD, MACP
Professor of Medicine
OHSU School of Medicine
Portland, OR

Treatment: From Oral Iron Supplementation to Intravenous Therapy
(duration 21:00)
Michael Auerbach, MD, FACP
Clinical Professor of Medicine
Georgetown University School of Medicine
Washington, DC

Provided by:

Original activity supported by an educational grant from: Luitpold Pharmaceuticals, Inc.

Learning Objectives

After completing the activity, clinicians will be better able to:

• Describe iron metabolism and the mechanism of iron deficiency and iron deficiency anemia
• Differentiate the causes of iron deficiency and iron deficiency anemia and confounding factors
• Evaluate the different approaches to diagnose iron deficiency and iron deficiency anemia
• Discuss the indications for intravenous iron therapy, the various formulations, and the benefits and risk of each

Target Audience

Hematologists, oncologists, and allied healthcare professionals who manage patients with iron deficiency anemia

Statement of Need

Iron deficiency (ID) and iron deficiency anemia (IDA) are common conditions worldwide, with 1.6 billion people in both developing and developed countries affected by these conditions, which can have serious consequences. Clinicians can readily diagnose ID and IDA in a healthy individual with a single cause of anemia. However, “explosive knowledge” of iron metabolism over the last 20 years has made it increasingly more difficult for them to determine the correct diagnosis and treatment [Camaschella, Blood Rev 2017]. This leaves clinicians uncertain as to the appropriate tests to order, how to interpret the results, what treatment to use, and at what dose. This activity is designed to clarify these issues and help the healthcare team provide optimal care for patients.

Disclosures

Maureen Achebe, MD (Presenter)
Consulting fees: Luitpold Pharmaceuticals, Inc., AMAG Pharmaceuticals, Inc., Syros Pharmaceuticals, Inc.

Michael Auerbach, MD (Course Director and Presenter)
Consulting fee: AMAG Pharmaceuticals, Inc., American Regent Luitpold, Pharmacosmos
Contracted research (Data management only): AMAG Pharmaceuticals, Pharmacosmos

Thomas DeLoughery, MD (Presenter)
No relevant financial relationships with a commercial interest.

Permissions

 Maureen Achebe presentation

• Slide 14: Functional Iron Deficiency

Republished with permission of the American Society of Hematology, from Bruganara C, et al. Red blood cell regeneration induced by subcutaneous recombinant erythropoietin: iron-deficient erythropoiesis in iron-replete subjects. Blood 1993; 81(4):956-64; permission conveyed through Copyright Clearance Center, Inc.

• Slide 22: Prevalence of Anemia by Cr and GFR in a Pre-dialysis Population

McClellan W, et al. The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin 2004;20(9):1501-10, reprinted by permission of the publisher (Taylor & Francis Ltd, http://www.tandfonline.com)

Michael Auerbach presentation

• Slide 9: Once vs Twice Daily Dosing

Reprinted from Lancet Haematol, Vol 4, No 11, Stoffel NU, Cercamondi CI, Brittenham G, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials, e524-e533, © 2017, with permission from Elsevier.

• Slide 22: Iron Deficiency in Infancy Alters Neural Correlates of Recognition Memory at 10 Years: Key Study Results

Reprinted from J Pediatr, Vol 160, Congdon EL, Westerlund A, Algarin CR, et al. Iron deficiency in infancy is associated with altered neural correlates of recognition memory at 10 years, pp 1027-1033, © 2012, with permission from Elsevier.

Thomas DeLoughery presentation

• Slide 12: [No title]

From N Engl J Med, Lipschitz DA, Cook, JD, Finch CA, A clinical evaluation of serum ferritin as an index of iron stores, Vol 290, pages 1213-1216, © 1974 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.

• Slide 15: Most Women Have Low Iron Stores

Reproduced with permission from JAMA, 1967, 199(12):897-900. Copyright© 1967 American Medical Association. All rights reserved

• Slide 16: Age and Ferritin

Reprinted from Am Heart J, Vol 140, Zacharski LR, Ornstein, DL, Woloshin S, et al. Association of age, sex, and race with body iron stores in adults: analysis of NHANES III data, pp 98-104, © 2000, with permission from Elsevier.

Disclaimer

The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Hemedicus, the supporter, or Frontline Medical Communications. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

Release Date: February 1, 2018

Expiration Date: January 31, 2019

Note: This activity is no longer available for credit

Agenda

Classification and Causes of Iron Deficiency and Iron Deficiency Anemia (duration 14:30)
Maureen M. Achebe, MD, MPH
Clinical Director, Non-Malignant Hematology Clinic
Dana-Farber Cancer Institute
Assistant Professor of Medicine
Harvard Medical School
Boston, MA

Diagnostic Approaches to Iron Deficiency Anemia:
Conventional Tests or Newer Assessments? (duration 13:00)
Thomas DeLoughery, MD, MACP
Professor of Medicine
OHSU School of Medicine
Portland, OR

Treatment: From Oral Iron Supplementation to Intravenous Therapy
(duration 21:00)
Michael Auerbach, MD, FACP
Clinical Professor of Medicine
Georgetown University School of Medicine
Washington, DC

Provided by:

Original activity supported by an educational grant from: Luitpold Pharmaceuticals, Inc.

Learning Objectives

After completing the activity, clinicians will be better able to:

• Describe iron metabolism and the mechanism of iron deficiency and iron deficiency anemia
• Differentiate the causes of iron deficiency and iron deficiency anemia and confounding factors
• Evaluate the different approaches to diagnose iron deficiency and iron deficiency anemia
• Discuss the indications for intravenous iron therapy, the various formulations, and the benefits and risk of each

Target Audience

Hematologists, oncologists, and allied healthcare professionals who manage patients with iron deficiency anemia

Statement of Need

Iron deficiency (ID) and iron deficiency anemia (IDA) are common conditions worldwide, with 1.6 billion people in both developing and developed countries affected by these conditions, which can have serious consequences. Clinicians can readily diagnose ID and IDA in a healthy individual with a single cause of anemia. However, “explosive knowledge” of iron metabolism over the last 20 years has made it increasingly more difficult for them to determine the correct diagnosis and treatment [Camaschella, Blood Rev 2017]. This leaves clinicians uncertain as to the appropriate tests to order, how to interpret the results, what treatment to use, and at what dose. This activity is designed to clarify these issues and help the healthcare team provide optimal care for patients.

Disclosures

Maureen Achebe, MD (Presenter)
Consulting fees: Luitpold Pharmaceuticals, Inc., AMAG Pharmaceuticals, Inc., Syros Pharmaceuticals, Inc.

Michael Auerbach, MD (Course Director and Presenter)
Consulting fee: AMAG Pharmaceuticals, Inc., American Regent Luitpold, Pharmacosmos
Contracted research (Data management only): AMAG Pharmaceuticals, Pharmacosmos

Thomas DeLoughery, MD (Presenter)
No relevant financial relationships with a commercial interest.

Permissions

 Maureen Achebe presentation

• Slide 14: Functional Iron Deficiency

Republished with permission of the American Society of Hematology, from Bruganara C, et al. Red blood cell regeneration induced by subcutaneous recombinant erythropoietin: iron-deficient erythropoiesis in iron-replete subjects. Blood 1993; 81(4):956-64; permission conveyed through Copyright Clearance Center, Inc.

• Slide 22: Prevalence of Anemia by Cr and GFR in a Pre-dialysis Population

McClellan W, et al. The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin 2004;20(9):1501-10, reprinted by permission of the publisher (Taylor & Francis Ltd, http://www.tandfonline.com)

Michael Auerbach presentation

• Slide 9: Once vs Twice Daily Dosing

Reprinted from Lancet Haematol, Vol 4, No 11, Stoffel NU, Cercamondi CI, Brittenham G, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials, e524-e533, © 2017, with permission from Elsevier.

• Slide 22: Iron Deficiency in Infancy Alters Neural Correlates of Recognition Memory at 10 Years: Key Study Results

Reprinted from J Pediatr, Vol 160, Congdon EL, Westerlund A, Algarin CR, et al. Iron deficiency in infancy is associated with altered neural correlates of recognition memory at 10 years, pp 1027-1033, © 2012, with permission from Elsevier.

Thomas DeLoughery presentation

• Slide 12: [No title]

From N Engl J Med, Lipschitz DA, Cook, JD, Finch CA, A clinical evaluation of serum ferritin as an index of iron stores, Vol 290, pages 1213-1216, © 1974 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.

• Slide 15: Most Women Have Low Iron Stores

Reproduced with permission from JAMA, 1967, 199(12):897-900. Copyright© 1967 American Medical Association. All rights reserved

• Slide 16: Age and Ferritin

Reprinted from Am Heart J, Vol 140, Zacharski LR, Ornstein, DL, Woloshin S, et al. Association of age, sex, and race with body iron stores in adults: analysis of NHANES III data, pp 98-104, © 2000, with permission from Elsevier.

Disclaimer

The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Hemedicus, the supporter, or Frontline Medical Communications. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.