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Lower molecular weight intravenous iron dextran for restless legs syndrome

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Author(s)
Yong Won ChoRichard P. AllenChristopher J. Earley
Keimyung Author(s)
Cho, Yong Won
Department
Dept. of Neurology (신경과학)
Journal Title
Sleep Medicine
Issued Date
2013
Volume
14
Issue
3
Keyword
Restless legs syndromeIron dextranCerebrospinal fluidFerritinTherapy
Abstract
Background: Various techniques used to assess brain iron concentrations have demonstrated the presence of low iron stores in patients with restless legs syndrome (RLS). Previous open-label and randomized studies generally support the value of iron treatment for RLS symptoms. Only one of these studies assessed iron therapy response to changes in brain iron status. The current study was designed to assess the effect of iron therapy on RLS symptoms and on CSF measures of brain iron status.
Methods: Idiopathic RLS patients drawn from the Korean population received four weekly intravenous (IV) doses of 250 mg low-molecular weight iron dextran for a total dose of 1g. One week after the last dose, any subject on RLS medication tapered off the RLS medications. Blood and CSF samples were taken to measure iron parameters at baseline and again, three weeks after the last dose. We have been following their response to the drug for two years after treatment.
Results: Twenty-five patients (age 55.2±9.3, 18 female) enrolled in this study without serious adverse reactions. Seventeen of the 25 patients (68%) showed moderate or complete improvement of all RLS symptoms after treatment based on the Korean-translated versions of the International RLS Severity scale (KIRLS). Changes in the K-IRLS did not correlate significantly with changes in CSF ferritin. The response to IV iron could not be predicted by patients’ demographics, or by blood or CSF iron baseline characteristics. RLS symptom improvement started between one and six weeks after treatment and the treatment benefits lasted from one month to 22 months. Fourteen patients, (56%) completely stopped all medications, for a mean duration of 31.3±33.1 weeks. These results are comparable to those from a prior study with high molecular weight dextran.
Conclusions: Intravenous low-molecular weight iron dextran produced significant improvement of RLS symptoms in a majority of patients without any significant adverse effects. Serious anaphylaxis occurs with high molecular weight, but rarely, if ever, with this low molecular weight dextran. Given apparent comparable efficacy the low molecular weight and not the high molecular weight iron dextran, should
be considered for RLS treatment. Although changes in CSF ferritin were seen following therapy, these changes were not related to clinical improvements.
Keimyung Author(s)(Kor)
조용원
Publisher
School of Medicine
Citation
Yong Won Cho et al. (2013). Lower molecular weight intravenous iron dextran for restless legs syndrome. Sleep Medicine, 14(3), 274–277. doi: 10.1016/j.sleep.2012.11.001
Type
Article
ISSN
1389-9457
Source
https://www.sciencedirect.com/science/article/pii/S1389945712004005?via%3Dihub
DOI
10.1016/j.sleep.2012.11.001
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34408
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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