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This combination therapy consists of **epoetin alfa**, a recombinant human erythropoietin, and **ferric carboxymaltose**, an intravenous iron replacement product. It is primarily utilized in the preoperative setting to optimize hemoglobin levels and treat anemia in pediatric patients undergoing major hemorrhagic surgeries, such as craniosynostosis repair. Epoetin alfa acts as an erythropoiesis-stimulating agent (ESA) by binding to the erythropoietin receptor to stimulate red blood cell production. Ferric carboxymaltose provides a rapidly available and highly bioavailable source of iron necessary to support the accelerated hemoglobin synthesis induced by the ESA. The University Hospital, Montpellier, has investigated this specific combination in the IRON KID trial to evaluate its efficacy in reducing perioperative blood transfusion requirements compared to standard oral iron supplementation.
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