Review Article

Management of Anemia of Inflammation in the Elderly

Table 1

Different options of treatment of anemia of inflammation in the elderly.

Treatment with clinical evidenceRationaleBenefits/risks

Erythropoietic stimulating agents (ESAs) EPO deficiencyHb increase, fatigue reduction, QL improvement/thrombotic events, decreased survival
Oral ironIron deficiency anemia (ferritin < 30 ng/mL)Hb increase/poor intestinal absorption, gastrointestinal side effects, poor compliance
IV Iron supplementation Anemia of inflammation with iron functional deficiencyImprovement of Hb response to ESAs/hospitalization, infusion reaction
LactoferrinAnemia of inflammation with iron functional deficiencyImprovement of Hb response to ESAs
Modulation of iron distribution
Reduction of inflammation/no severe side effects

Emerging drugsRationale Evidence

Hepcidin antagonistsHepcidin-mediated iron restriction in anemia of inflammationPreclinical studies
Anti IL-6 monoclonal Ab
Anemia of inflammationOne phase II clinical trial
Activators of autophagy (rapamycin)Anemia of inflammationPreclinical studies
AMPK activators (metformin, curcumin, etc.)Anemia of inflammation Preclinical studies
Nutraceuticals (spirulina, curcumin, ginkgo biloba, ginseng, fermented papaya)Modulation of oxidative stress and inflammationPreclinical and phase II clinical trials