Clinical experience with ferric carboxymaltose in the treatment of cancer- and chemotherapy-associated anaemia.

BACKGROUND: Intravenous (i.v.) iron can improve anaemia of chronic disease and response to erythropoiesis-stimulating agents (ESAs), but data on its use in practice and without ESAs are limited. This study evaluated effectiveness and tolerability of ferric carboxymaltose (FCM) in routine treatment of anaemic cancer patients. PATIENTS AND METHODS: Of 639 patients enrolled in 68 haematology/oncology practices in Germany, 619 received FCM at the oncologist's discretion, 420 had eligible baseline haemoglobin (Hb) measurements, and 364 at least one follow-up Hb measurement. Data of transfused patients were censored from analysis before transfusion. RESULTS: The median total iron dose was 1000 mg per patient (interquartile range 600-1500 mg). The median Hb increase was comparable in patients receiving FCM alone (1.4 g/dl [0.2-2.3 g/dl; N = 233]) or FCM + ESA (1.6 g/dl [0.7-2.4 g/dl; N = 46]). Patients with baseline Hb up to 11.0 g/dl and serum ferritin up to 500 ng/ml benefited from FCM treatment (stable Hb ≥ 11.0 g/dl). Also patients with ferritin >500 ng/ml but low transferrin saturation benefited from FCM treatment. FCM was well tolerated, 2.3% of patients reported putative drug-related adverse events. CONCLUSIONS: The substantial Hb increase and stabilisation at 11-12 g/dl in FCM-treated patients suggest a role for i.v. iron alone in anaemia correction in cancer patients.

Teaching medical students about over-the-counter medications.

OBJECTIVES: Over-the-counter (OTC) medications account for over half of US drug expenses but have received little attention in medical school education. This pilot study evaluated student attitudes and knowledge in connection with a new curriculum in an ambulatory teaching clinic. DESIGN: Learning objectives were developed for six categories of OTC medications and students taught each other under the direction of a clinical pharmacist and family physician. Learning was undertaken in small groups and a site visit to a pharmacy was included. A 25-question test of knowledge was administered before and 6 months after the project, and student attitudes were assessed. SETTING: The sessions were taught as part of a longitudinal family medicine clerkship at an ambulatory care teaching clinic, Rockford, Illinois, USA. SUBJECTS: Twenty third-year medical students took the pre-test and attended the educational sessions; 19 completed the post-test and 16 completed the attitudinal survey. RESULTS: The mean pre-test score of 49% improved to 67% on the post-test (p<0.001). On the survey, 94% found the material useful and 88% liked the small group learning, but only 60% felt the pharmacy trip was worthwhile. CONCLUSION: In this study, medical students found teaching about OTC medications to be useful and showed significant improvement on a fund of knowledge test.