ArticleThe Journal of clinical endocrinology and metabolism2022
Risk Factors for and Effects of Persistent and Severe Hypophosphatemia Following Ferric Carboxymaltose.
Article in The Journal of clinical endocrinology and metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Indications for the evaluation and supplementation of hypophosphatemia: an umbrella systematic review of reviews and guidelines.BMC medicine · 2025Pooled it
- Ferric Carboxymaltose (FCM)-Associated Hypophosphatemia (HPP): A Systematic Review.American journal of hematology · 2025Pooled it
- Hypophosphatemia attenuates improvements in vitality after intravenous iron treatment in patients with inflammatory bowel disease.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Trial
- Impact of Intravenous Iron Substitution on Serum Phosphate Levels and Bone Turnover Markers-An Open-Label Pilot Study.Nutrients · 2023Trial
- Symptomatic Ferric Carboxymaltose-Induced Hypophosphataemia: A Case Series of 11 Patients.EJHaem · 2026Article
- Hypophosphatemia in Patients Receiving Intravenous Iron Supplementation for Iron-Deficiency Anemia: A Narrative Review.Journal of clinical medicine · 2026Review
- Recurrent Severe Hypophosphatemia Following Intravenous Ferric Carboxymaltose Infusion: A Case Report.Cureus · 2026Article
- The Significance of Hypophosphatemia in Deciding on an Optimal Clinical Choice of Parenteral Iron Therapy in Patients with Chronic Inflammatory Bowel Disease in Slovenia: An Umbrella Review and Economic Evaluation.Healthcare (Basel, Switzerland) · 2026Article
- Electromagnetic fields regulate iron metabolism: From mechanisms to applications.Journal of advanced research · 2026Review
- Perioperative Hypophosphatemia Following a Fixed High-Dose Ferric Carboxymaltose Protocol in Staged Bilateral Total Knee Arthroplasty: A Retrospective Cohort Study.International journal of general medicine · 2026Article
- "Double trouble": the impact of iron infusion and antiresorptive therapy on calcium-phosphate homeostasis.JBMR plus · 2025Article
- Prevalence, predictors, and natural history of hypophosphatemia following iron infusion.JBMR plus · 2025Article
- Iron-Induced Hypophosphatemia: A Review of Pathophysiology, Drug Safety, and Pharmacogenomic Perspectives.Journal of hematology · 2025Review
- Intravenous administration of ferric derisomaltose is associated with a higher incidence of infusion reactions than ferric carboxymaltose, and unaffected by dilution volume.Internal medicine journal · 2025Article
- Understanding and Managing Infusion Reactions and Hypophosphataemia With Intravenous Iron-A Nurses' Consensus Paper.Nursing open · 2025Article
- Diagnosis and treatment of iron deficiency in chronic heart failure : Position statement of the heart failure working group of the Austrian Society of Cardiology.Wiener klinische Wochenschrift · 2025Article
- No longer to be ignored: Hypophosphatemia following intravenous iron administration.Reviews in endocrine & metabolic disorders · 2025Review
- Comparative Impact of Intravenous Iron Sucrose and Ferric Carboxymaltose on Hypophosphatemia and Anemia Parameters in Iron Deficiency Anemia: A Retrospective Study.Therapeutics and clinical risk management · 2025Article
- The impact of monoallelic inactivation mutations in the ENPP1 gene on pediatric skeletal development: a case report and literature review.Frontiers in endocrinology · 2025Review
- Severe Hypophosphatemia After Ferric Carboxymaltose Infusion: A Case Report.Hospital pharmacy · 2024Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextHypophosphatemia, osteomalacia, and fractures are complications of certain intravenous iron formulations.
objectiveThis study investigated risk factors for incident, severe, and persistent hypophosphatemia, and associated alterations in bone and mineral biomarkers following intravenous iron treatment.
methodsWe analyzed data from the PHOSPHARE-IDA randomized clinical trials, comprising 245 patients aged 18 years or older with iron deficiency anemia at 30 outpatient clinics in the United States who received intravenous ferric carboxymaltose (FCM) or ferric derisomaltose (FDI). Outcome measures included serum phosphate, intact fibroblast growth factor-23 (iFGF23), 1,25-dihydroxyvitamin D (1,25(OH)2D), ionized calcium, parathyroid hormone (PTH), and alkaline phosphatase.
resultsFCM was the only consistent risk factor for incident hypophosphatemia (< 2.0 mg/dL; odds ratio vs FDI: 38.37; 95% CI: 16.62, 88.56; P < 0.001). Only FCM-treated patients developed severe hypophosphatemia (< 1.0 mg/dL; 11.3%; 13/115) or persistent hypophosphatemia (< 2.0 mg/dL at study end; 40.0%; 46/115). More severe hypophosphatemia associated with significantly greater increases in iFGF23, PTH, and alkaline phosphatase, and more severe decreases in 1,25(OH)2D and ionized calcium (all P < 0.05). Patients with persistent vs resolved hypophosphatemia demonstrated significantly greater changes in iFGF23, PTH, 1,25(OH)2D, and N-terminal procollagen-1 peptide levels (all P < 0.01), but alkaline phosphatase increased similarly in both groups.
conclusionTreatment with FCM was the only consistent risk factor for hypophosphatemia. Patients who developed severe or persistent hypophosphatemia after FCM treatment manifested more severe derangements in bone and mineral metabolism. Changes in bone biomarkers continued beyond resolution of hypophosphatemia, suggesting ongoing effects on bone that may help explain the association of FCM with osteomalacia and fractures.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.