Iron therapy for preoperative anaemia

In The Lancet Haematology, Talboom and colleagues 1 Talboom K Borstlap WAA Roodbeen SX et al. Ferric carboxymaltose infusion versus oral iron supplementation for preoperative iron deficiency anaemia in patients with colorectal cancer (FIT): a multicentre, open-label, randomised, controlled trial. Lancet Haematol. 2023; (published online Feb 27.)https://doi.org/10.1016/S2352-3026(22)00402-1 Summary Full Text Full Text PDF Scopus (2) Google Scholar report the FIT multicentre, open-label, randomised, controlled trial (RCT) in 202 patients with colorectal cancer and iron deficiency anaemia randomly assigned to either oral or intravenous iron 2–3 weeks before surgery. The primary endpoint was correction of anaemia at the time of surgery. Additional endpoints included perioperative blood transfusion, patient complications, and length of hospital stay. The main trial analysis showed no difference between the two groups in any predefined endpoints. This trial helps resolve the fractured debate between opinions and guidelines proposing the use of intravenous iron therapy for preoperative anaemia 2 National Institute for Health and Care ExcellenceBlood transfusion: NICE guideline [NG24]: alternatives to blood transfusion for patients having surgery: intravenous and oral iron. www.nice.org.uk/guidance/ng24/chapter/Recommendations#intravenous-and-oral-iron-2Date: Nov 18, 2015 Date accessed: January 10, 2023 Google Scholar and results of RCTs 3 Ng O Keeler BD Mishra A et al. Iron therapy for preoperative anaemia. Cochrane Database Syst Rev. 2019; 12CD011588 Google Scholar that have not shown patient benefit in the perioperative period. Ferric carboxymaltose infusion versus oral iron supplementation for preoperative iron deficiency anaemia in patients with colorectal cancer (FIT): a multicentre, open-label, randomised, controlled trialNormalisation of haemoglobin before surgery was infrequent with both treatment regimens, but significantly improved at all other timepoints following intravenous iron treatment. Restoration of iron stores was feasible only with intravenous iron. In selected patients, surgery might be delayed to augment the effect of intravenous iron on haemoglobin normalisation. Full-Text PDF