Iron Deficiency in Pediatric Patients

ACCRUFeR® (ferric maltol) is the only FDA-approved branded oral iron treatment for children 10 years of age and older.2,60

2.4 million children in the U.S. have ID/IDA58

Left untreated, ID can lead to long-term issues that may not be reversable including:59 

  • Neurocognitive deficits: Impaired attention, memory, and information processing.
  • Developmental motor delays: Impaired motor skills and coordination.
  • Behavioral dysfunction: Compromised emotional regulation and reduced inhibitory function.
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Up to 60% of patients will discontinue treatment with traditional ferrous salts because of adverse reactions.32

An effective, tolerable iron treatment option is critical to raise iron levels and reduce the risk of long-term health impacts for children with iron deficiency.

The ACCRUFeR impact

ACCRUFeR achieved FDA approval based on three randomized, placebo-controlled trials in adults and one open-label study in children.2 For pediatric patients, ACCRUFeR’s MALTOL SHIELD™ makes the difference, demonstrating the following benefits:

MALTOL SHIELD(TM) closed: Protects iron from oxidizing in the stomach MALTOL SHIELD (TM) opened: Releases iron only when ready for absorption in the small intestine Unused ACCRUFeR excreted: Stays protected, helping patients avoid free iron and irritation

ACCRUFeR’s safety profile in children with IDA is consistent with the safety profile reported in adult patients with IDA.2

In adult studies, ACCRUFeR demonstrated a 2.25 g/dL mean Hb change (vs 0.06 g/dL with placebo) from baseline to week 12. Statistical significance achieved by week 4.1,2

Patients take a 30 mg gluten-free capsule twice a day. With this dosing in adult studies, treatment did not lead to iron overload.2

In adult studies, 4.6% of patients taking ACCRUFeR (n=175) discontinued treatment due to adverse GI reactions, compared with 2.5% of patients taking a placebo (n=120).2,7

Proven efficacy in pediatric patients

ACCRUFeR demonstrated safety and efficacy in pediatric patients (ages 10 to <18) with IDA.2

Young teen girl smiling in front of a yellow background

*Not actual patient.

Pediatric Patients with IDA2

Endpoint ACCRUFeR

Primary: Hb g/dL
Mean (SD) change at Week 12

+1.10 (1.06)
Baseline (BL): 10.73 (0.89)

Secondary: Ferritin, mcg/L
Mean (SD) change at Week 12

+8.6 (10.29)
BL: 11.4 (10.06)

Study Description:2

  • 12-week open-label study
  • 24 patients ages 10 to <18 years with IDA

References:
1. Schmidt C, Ahmad T, Tulassay Z, et al. Ferric maltol therapy for iron deficiency anaemia in patients with inflammatory bowel disease: long-term extension data from a phase 3 study. Aliment Pharmacol Ther. 2016;44(3):259-270. doi:10.1111/apt.13665
2. ACCRUFeR®full prescribing information. Shield Therapeutics, 2025.
3. Stallmach A, Büning C. Ferric maltol (ST10): a novel oral iron supplement for the treatment of iron deficiency anemia in inflammatory bowel disease. Expert Opin Pharmacother. 2015;16(18):2859-2867. doi:10.1517/14656566.2015.1096929
4. European Medicines Agency. https://www.ema.europa.eu/en/documents/variation-report/feraccru-h-c-2733-ii-0010-epar-assessment-report-variation_en.pdf
5. Gasche C, Ahmad T, Zsolt T, et al. Ferric maltol is effective in correcting iron deficiency anemia in patients with inflammatory bowel disease: results from a phase-3 clinical trial program. Inflamm Bowel Dis. 2015;21:579-588.
6. Pergola PE, Kopyt NP. Oral ferric maltol for the treatment of iron-deficiency anemia in patients with CKD: a randomized trial and open-label extension. Am J Kidney Dis. 2021;78(6):846-856.el. doi:10.1053/j.ajkd.2021.03.020
7. Data on file. Shield Therapeutics Inc. 2019.
32. Cancelo-Hidalgo MJ, Castelo-Branco C, Palacios S, et al. Tolerability of different oral iron supplements: A systematic review. Curr Med Res Opin. 2013;29(4):291-303. doi:10.1185/03007995.2012.761599.
58. Brotanek JM, et al (2007)
59. Theola J, Andriastuti M. Neurodevelopmental impairments as long-term effects of iron deficiency in early childhood: A systematic review. Balkan Med J. 2025;Mar 3;42(2):108-120. doi: 10.4274/balkanmedj. galenos.2025.2024-11-24. Epub 2025 Jan 31
60. Data on File. Shield Therapeutics Inc. 2025