Steven Fein, MD, is a telehealth hematologist with HemeOnCall. 

Steven Fein, MD

Improving Management of Iron Deficiency, with Steven Fein, MD

In the fifth and final segment of this video series, which highlights advances in hematology from 2024, Steven Fein, MD, a telehealth hematologist with HemeOnCall takes a deep dive into what he believes next year will hold for the hematology community as well as the importance of iron deficiency awareness among family or internal medicine practitioners. Fein begins by emphasizing the importance of identifying and treating iron deficiency, particularly in pregnant women, to improve maternal and fetal health outcomes. He underscores ongoing research exploring the potential effects of iron deficiency on offspring well-being and cognitive development. Fein stresses universal iron testing and treatment for pregnant women must become standard practice, highlighting its relevance not only for managing fatigue but also for ensuring optimal outcomes for both mother and child.

Expanding on the broader implications, Fein notes that iron deficiency is prevalent in one-third of all women, with ferritin levels below 30, posing significant barriers to women’s overall wellness, work performance, and concentration. He frames iron deficiency as a contributor to gender inequality, as women are disproportionately affected compared to men. Fein calls for increased awareness and testing across specialties—OBGYN for pregnant women and family or internal medicine for non-pregnant women—emphasizing the need for separate iron testing beyond routine hemoglobin measurements.

Relevant disclosures for Fein include Pharmacosmos Therapeutics, Sobi, Amgen, Agios, BeiGene, and others.

Videos

A hematologist discusses the role of internal and family medicine practitioners in improving the diagnosis and management of iron deficiency. 

Updates, News in Sickle Cell Disease, with Steven Fein, MD

In part 4 of our 5-part series highlighting updates in hematology from 2024, Steven Fein, MD, a telehealth hematologist with HemeOnCall, discusses updates within sickle cell during the past year. Fein addresses setbacks and ongoing challenges in the hematology landscape for 2024. He notes the removal of voxelotor for sickle cell disease following findings that it was less effective than initially anticipated, leaving patients with fewer treatment options. While the approval of gene therapy for sickle cell disease in 2023 was a milestone, Fein believes routine implementation remains far off, emphasizing the need for better palliative treatments in the interim.

He also highlights the growing focus on access to care and equity in hematology, though progress has been slow. Fein points to issues like reduced access to chronic myeloid leukemia (CML) treatments as certain medications go generic, limiting patient assistance programs. Despite advances, he observes a lack of substantial improvement in access and coverage for patients, underscoring persistent barriers in equitable care delivery.

Steven Fein, MD, discusses news and updates in sickle cell disease following ASH 2024. 

Hematology Pipelines, Trials to Watch, with Steven Fein, MD

In part 3 of our 5-part series highlighting ASH 2024 and updates in hematology, Steven Fein, MD, a telehealth hematologist with HemeOnCall, highlights ongoing advancements in clinical trials addressing iron deficiency and hematologic conditions. He discusses a large randomized clinical trial in pregnant women with iron deficiency, comparing oral versus IV iron in a blinded fashion, with a placebo infusion arm ensuring participants remain unaware of their treatment group.

Additionally, Fein points to promising developments in sickle cell disease treatment and breakthrough clinical trials in beta-thalassemia. Both transfusion-dependent and non-transfusion-dependent beta-thalassemia patients have been studied, with the investigational medication mitapivat showing potential. Fein notes that these trials are concluding and will soon undergo FDA review, marking a significant step forward for treatment options in these patient populations.

In this video, a hematologist discusses trials and areas of advancement he is excited about in the current landscape. 

Clinically Relevant Updates in Iron Deficiency, with Steven Fein, MD

In part 2 of our 5-part video series, Steven Fein, MD, a telehealth hematologist with HemeOnCall, highlights a significant issue in the iron deficiency space: the US Preventive Services Task Force's 2024 decision not to recommend routine iron testing for pregnant women, citing insufficient evidence. Fein explains the resulting confusion, as many interpret this stance to mean iron testing is unnecessary, despite the common symptom of fatigue during pregnancy, which alone warrants testing. He underscores the difference between iron testing and hemoglobin testing, stressing the importance of screening for ferritin levels in this population.

Fein discusses findings from his own research, presented at ASH 2024, which revealed that 90% of pregnant women screened had ferritin levels below 30, confirming the widespread prevalence of iron deficiency during pregnancy. He attributes this to the substantial iron demands of the developing fetus and calls for a clearer approach to routine iron screening to address this pervasive yet often overlooked issue.

In part 2 of our 5-part series, Steven Fein, MD, discusses updates in iron deficiency management from 2024. 

Steven Fein, MD

Articles