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However, evidence suggests that some patients receive less IV iron than needed. This retrospective audit assessed the effectiveness and safety of ferric derisomaltose (FDI), a high-dose IV iron, in 2,468 patients. Efficacy outcomes assessed at 4\u201312\u00a0weeks post-infusion included changes in hemoglobin (Hb) and ferritin, proportion of courses (a course was defined as the treatment episode required to administer one total dose) after which patients were non-anemic (Hb\u2009\u2265\u2009130\u00a0g\/L [men] or\u2009\u2265\u2009120\u00a0g\/L [women]), and response rate (proportion of courses after which patients were non-anemic or Hb increased by\u2009\u2265\u200920\u00a0g\/L). Safety was assessed through adverse events. Across 2,775 FDI courses, the mean dose was 1,244\u00a0mg, but mean estimated iron need was 1,580\u00a0mg. At follow-up, mean Hb had increased by 20.9\u00a0g\/L and mean ferritin by 188.8\u00a0\u00b5g\/L. Patients were non-anemic after 33.4% (n\u2009=\u2009494\/1,478) of courses and responded after 65.1% (n\u2009=\u2009962\/1,478) of courses. One patient (n\u2009=\u20091\/2,468; 0.04%) had a serious allergic reaction. Patients remained anemic after\u2009&gt;\u200965% of courses, demonstrating the need to optimize dosing based on iron need.<\/jats:p>","DOI":"10.1038\/s41598-025-85880-9","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T13:20:47Z","timestamp":1744204847000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-world evaluation of an intravenous iron service for the treatment of iron deficiency with or without anemia"],"prefix":"10.1038","volume":"15","author":[{"given":"Roel","family":"Fijn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans C.","family":"Ablij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter D.","family":"Knoester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M. 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