Table 1.

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

Treatment with clinical evidence	Rationale	Benefits/risks
Erythropoietic stimulating agents (ESAs)	EPO deficiency	Hb increase, fatigue reduction, QL improvement/thrombotic events, decreased survival
Oral iron	Iron 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 deficiency	Improvement of Hb response to ESAs/hospitalization, infusion reaction
Lactoferrin	Anemia of inflammation with iron functional deficiency	Improvement of Hb response to ESAs Modulation of iron distribution Reduction of inflammation/no severe side effects
Emerging drugs	Rationale	Evidence
Hepcidin antagonists	Hepcidin-mediated iron restriction in anemia of inflammation	Preclinical studies
Anti IL-6 monoclonal Ab	Anemia of inflammation	One phase II clinical trial
Activators of autophagy (rapamycin)	Anemia of inflammation	Preclinical studies
AMPK activators (metformin, curcumin, etc.)	Anemia of inflammation	Preclinical studies
Nutraceuticals (spirulina, curcumin, ginkgo biloba, ginseng, fermented papaya)	Modulation of oxidative stress and inflammation	Preclinical and phase II clinical trials