ferrous-fumarate and Anemia

To determine whether intravenous (IV) or oral iron suppletion is superior in improving physical fitness in anemic children with inflammatory bowel disease (IBD).. We conducted a clinical trial at 11 centers. Children aged 8-18 with IBD and anemia (defined as hemoglobin [Hb] z-score < -2) were randomly assigned to a single IV dose of ferric carboxymaltose or 12 weeks of oral ferrous fumarate. Primary end point was the change in 6-minute walking distance (6MWD) from baseline, expressed as z-score. Secondary outcome was a change in Hb z-score from baseline.. We randomized 64 patients (33 IV iron and 31 oral iron) and followed them for 6 months. One month after the start of iron therapy, the 6MWD z-score of patients in the IV group had increased by 0.71 compared with -0.11 in the oral group (P = .01). At 3- and 6-month follow-ups, no significant differences in 6MWD z-scores were observed. Hb z-scores gradually increased in both groups and the rate of increase was not different between groups at 1, 3, and 6 months after initiation of iron therapy (overall P = .97).. In this trial involving anemic children with IBD, a single dose of IV ferric carboxymaltose was superior to oral ferrous fumarate with respect to quick improvement of physical fitness. At 3 and 6 months after initiation of therapy, no differences were discovered between oral and IV therapies. The increase of Hb over time was comparable in both treatment groups.. NTR4487 [Netherlands Trial Registry].

Topics: Administration, Oral; Anemia; Anemia, Iron-Deficiency; Child; Ferric Compounds; Hemoglobins; Humans; Inflammatory Bowel Diseases; Iron; Maltose; Treatment Outcome

Iron deficiency anemia (IDA) is a common health problem in developing countries. Many studies have shown that low-dose oral iron could have similar efficacy and less gastrointestinal effects in iron deficiency without anemia. This prospective open-labeled randomized controlled study was designed to compare the response of 200 mg ferrous fumarate thrice-weekly (TIW) as not inferior to the thrice-daily (TID) regimen and to assess the incidence of adverse events (AEs) between two regimens in treating adult patients with IDA. The primary endpoint was either an increase in Hb ≥ 3 g/dL, having Hb of 12 g/dL in females or 13 g/dL in males at the 12th week of treatment. Secondary outcomes included adverse events (AEs), red blood cell indices, iron profiles, and patient compliance. Sixty-four patients were randomized: 32 in the TIW arm and the other 32 in the TID arm. The response rates were not different between two arms either with intention to treat analysis (72.0%, 95%CI 56.6-88.5 vs. 71.9%, 95%CI 53.3-86.3, p = 0.777); or per-protocol analysis (88.9%, 95%CI 70.8-97.6 vs. 88.5%, 95%CI 69.8-97.6, p = 1.0), respectively. The trial demonstrated non-inferiority at a margin of 23%. Although the iron profile response of the TID arm was earlier than the TIW arm, almost all patients recovered from anemic symptoms at week 4, and hematologic responses were not different at week 12. There were more gastrointestinal AEs in the TID arm. In conclusion, this study showed that the TIW was non-inferior to the TID iron treatment of IDA patients but less AEs and costs.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; Female; Ferrous Compounds; Hemoglobins; Humans; Iron; Male; Prospective Studies

To evaluate the efficacy of adding folic acid to oral iron supplementation in postpartum women with anemia.. A randomized controlled trial was conducted in the Netherlands between April 8, 2008, and August 31, 2010. A total of 112 postpartum women with anemia (hemoglobin <10.5 g/dL) were randomly allocated to receive 600 mg/day ferrous fumarate plus 1mg/day folic acid (FFFA group) or 600/day ferrous fumarate alone (FF group) for 4 weeks. Primary outcome measures were hemoglobin and health status. Secondary outcome measures were fatigue, compliance, and adverse reactions.. No between-group differences were observed in hemoglobin and health status after treatment, and no differences were found in fatigue scores. Approximately 75% of all women reported having at least one symptom resulting from ferrous fumarate use. Constipation caused by ferrous fumarate was significantly associated with non-compliance (P=0.014).. The addition of folic acid to iron supplementation is not beneficial in women with postpartum anemia, as it has no effect on hematologic or health status parameters.. CCMO website NL21797.028.08 and Netherlands Trial Register NTR2232.

Topics: Adult; Anemia; Dietary Supplements; Drug Therapy, Combination; Female; Ferrous Compounds; Folic Acid; Health Status; Hemoglobins; Humans; Intention to Treat Analysis; Puerperal Disorders; Surveys and Questionnaires

We evaluated the adverse effect of asymptomatic Helicobacter pylori infection in children on the response to Fe supplementation. One hundred and sixty-nine children aged 1-10 years from the urban poor community underwent a [13C]urea breath test for H. pylori and haematological tests at admission and after 8 weeks. Both H. pylori-positive and -negative children were randomly assigned to receive ferrous fumarate syrup (20 mg elemental Fe twice daily) or placebo for 8 weeks and a single dose of vitamin A (33,000 microg). Admission findings were compared between H. pylori-positive and -negative children. Response to Fe was compared between Fe-supplemented H. pylori-positive and -negative children. Seventy-nine per cent of the children were aged 1-5 years and half of them were boys. In eighty-five H. pylori-positive and eighty-four H. pylori-negative children, the differences in mean Hb (112 (sd 12.6) v. 113 (sd 12.0) g/l), haematocrit (34 (sd 3.5) v. 35 (sd 3.2) %) and ferritin (23.8 v. 21.0 microg/l) were similar. After 8 weeks of Fe supplementation, mean Hb was 5.3 g/l more (95 % CI 1.59, 9.0) and haematocrit was 1.4 % more (95 % CI 0.2, 2.6) in H. pylori-negative (n 44) compared with H. pylori-positive (n 42) children. Mean ferritin was similar at admission and improved in both H. pylori-positive and -negative children. Asymptomatic H. pylori infection was not associated with higher rates of anaemia or Fe deficiency in children, but had a significant adverse effect on response to Fe therapy. However, this result is based on exploratory analysis and needs confirmation.

Topics: Anemia; Child; Child, Preschool; Dietary Supplements; Female; Ferritins; Ferrous Compounds; Helicobacter Infections; Helicobacter pylori; Hematocrit; Hemoglobins; Humans; Infant; Iron; Male; Vitamin A; Vitamins

Impaired uteroplacental perfusion has been shown to play a role in the pathogenesis of some complicated pregnancies with placenta insufficiency. Apart from this, lower oestrogen, magnesium and zinc are found in many of these conditions in the third trimester with placenta insufficiency. In this study, we examined the effect of a 4 mg intravenous dexamethasone injection on estriol, since maternal cortisol or synthetic corticosteroids cross the placental barrier and inhibit the release of dehydroepiandrostesone sulfate in the fetal adrenals. Dexamathasone was found to suppress estriol levels in all groups but a significant difference in suppression was found between the Chemiron--a new combination hematinic--and the control single iron therapy groups. Our preliminary results showed that Chemiron has a protective effect on the development of placenta insufficiency during the third trimester of pregnancy.

Topics: Adult; Anemia; Ascorbic Acid; Dexamethasone; Drug Combinations; Estriol; Female; Ferrous Compounds; Folic Acid; Hematinics; Humans; Magnesium Sulfate; Placental Insufficiency; Pregnancy; Pregnancy Tests; Pregnancy Trimester, Third; Vitamin B 12; Zinc Sulfate

Iron supplementation is required by most dialysis patients receiving recombinant human erythropoietin. The efficacy of oral iron is variable in these patients, and many require the use of intravenous iron dextran to maintain adequate iron levels, defined as transferrin saturation greater than 20%, serum ferritin greater than 100 ng/mL, and serum iron greater than 80 micrograms/dL. To determine the efficacy of different oral iron preparations in maintenance of iron status, we prospectively studied 46 recombinant human erythropoietin-treated patients and randomized them to receive different oral iron preparations. These four preparations included Chromagen (ferrous fumarate; Savage Laboratories, Melville, NY), Feosol (ferrous sulfate; SmithKline Beecham, Inc, Pittsburgh, PA), Niferex (polysaccharide; Central Pharmaceuticals, Inc, Seymour, IN), or Tabron (ferrous fumarate; Parke-Davis, Morris Plains, NJ). All patients were prescribed approximately 200 mg of elemental iron daily of their assigned iron preparation with at least 100 mg ascorbic acid daily for 6 months. At baseline and bimonthly during the study, serum iron, transferrin saturation, ferritin, hematocrit, and recombinant human erythropoietin dose were monitored; in addition, compliance and side effects were recorded by patient interview. All patients were able to maintain target hematocrit during the 6 months of study. However, there were differences in the trends of serum iron, percent transferrin saturation, and ferritin when considered singly or in combination between the four groups of iron medications. The percent of laboratory values measured over the study period in each group that met the criteria of transferrin saturation more than 20% was greatest in the Tabron group (58%), followed by the Feosol (47%), Chromagen (33%), and Niferex (31%) groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Oral; Anemia; Anemia, Iron-Deficiency; Delayed-Action Preparations; Erythropoietin; Female; Ferrous Compounds; Hematocrit; Humans; Iron; Kidney Failure, Chronic; Male; Middle Aged; Patient Compliance; Polysaccharides; Prospective Studies; Recombinant Proteins; Renal Dialysis

Topics: Adolescent; Anemia; Antimalarials; Child; Child, Preschool; Female; Ferrous Compounds; Folic Acid; Folic Acid Deficiency; Humans; Infant; Iron; Iron-Dextran Complex; Malaria; Male; Nigeria

Following the 2008 Wenchuan earthquake, the Chinese government instituted an infant and young and child nutrition program that included promotion of in-home fortification of complementary food with ying yang bao (YYB), a soy-based powder containing iron, 2.5 mg as iron-EDTA and 5 mg as ferrous fumarate, and other micronutrients. Ying yang bao was provided to participating families in 8 poor rural counties in Sichuan, Shaanxi, and Gansu provinces by the Ministry of Health. We assessed hemoglobin levels among infants and young children (IYC) aged 6 to 23 months at baseline in May 2010 (n = 1290) and during follow-up in November 2010 (n = 1142), May 2011 (n = 1118), and November 2011 (n = 1040), using the Hemocue method. Interviewers collected basic demographic information and child feeding practices from the children's caretakers. Altitude-adjusted hemoglobin level averaged 10.8 g/dL, and total anemia prevalence was 49.5% at baseline. Average hemoglobin was 11.3 g/dL at 6 months, 11.6 g/dL at 12 months, and 11.7 g/dL at 18 months after introduction of YYB. Moderate anemia (hemoglobin: 70-99 g/dL) decreased from 20.3% at baseline to 7.5%, 5.8%, and 7.3% after 6, 12, and 18 months of home fortification, respectively (P < .001), whereas mild anemia (hemoglobin: 100-110 g/dL) decreased from 29.0% to 16.7%, 18.1%, and 15.4%, respectively (P < .001). Among infants aged 6 to 23 months, 95% had regularly been fed YYB during the observation period. Regression analysis showed that the duration of YYB consumption and number of sachets consumed per week correlated positively with hemoglobin levels and negatively with anemia rates. Home food fortification with YYB is feasible and effective for nutrition promotion among IYC in high-risk regions of China.

Topics: Anemia; Anemia, Iron-Deficiency; China; Dietary Supplements; Edetic Acid; Ferrous Compounds; Food Assistance; Food, Fortified; Glycine max; Government Programs; Hemoglobins; Humans; Infant; Infant Nutritional Physiological Phenomena; Iron Deficiencies; Iron, Dietary; Poverty; Rural Population

To evaluate the use of reticulocyte hemoglobin content (CHr) and mean corpuscular volume (MCV) to identify truly iron-deficient women with postpartum anemia (PPA), in order to reduce unnecessary iron supplementation.. Three hundred women with more than 500 mL of blood loss or clinical signs of anemia were divided in a control (Hb ≥ 10.5 g/dL, N = 150) and postpartum anemia group (PPA, Hb < 10.5 g/dL; N = 150). PPA women were given ferrous fumarate for a period of 4 weeks. Efficacy of the treatment was evaluated by comparing Hb, CHr, and MCV at baseline (T(0)) and after 4 weeks (T(4)). Using standard iron deficiency cut off values for MCV (80 fL) and CHr (28 pg) at T(0), we divided the PPA group of both parameters into two subgroups, one suggestive for iron deficiency and one suggestive for noniron deficiency.. Irrespective of the parameter or the subdivision, delta Hb concentrations (T(4) -T(0)) showed a similar increase in all PPA subgroups investigated. Both parameters in the PPA subgroups below their respective cut off value showed a significant improvement toward normalization, while the MCV and CHr in the PPA subgroups above their respective cut off value did not show any significant increase.. Our data suggest that the etiology of the anemia in postpartum anemic women is not always iron deficiency. Using a combination of Hb, MCV and CHr, we increased the stringency to identify truly iron-deficient postpartum anemic women, thereby reducing unnecessary iron supplementation in those women with sufficient iron stores.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; Erythrocyte Indices; Female; Ferrous Compounds; Hemoglobins; Humans; Postpartum Period; Predictive Value of Tests; Reticulocytes; Time Factors; Trace Elements; Young Adult

Oral iron replacement therapy with Chromagen, containing ferrous fumarate, and Niferex, containing polysaccharide iron complex, can successfully maintain hematologic and iron indices in dialysis clients and demonstrated fewer adverse effects in selected clients. Their multiple ingredient dose forms, which further support erythropoiesis, and their possible decrease in distressing side effects should enhance client compliance, making these two drugs excellent alternatives to traditional iron therapies.

Topics: Administration, Oral; Anemia; Contraindications; Ferric Compounds; Ferric Oxide, Saccharated; Ferrous Compounds; Glucaric Acid; Humans; Kidney Diseases; Renal Dialysis

Topics: Anemia; Blood Transfusion; Drug Therapy; Female; Ferrous Compounds; Humans; Iron; Pregnancy; Puerperal Disorders; Vitamins

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Drug Therapy; Female; Ferrous Compounds; Fumarates; Humans; Iron; Postpartum Period; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders

Topics: Anemia; Anemia, Hypochromic; Feces; Ferrous Compounds; Fumarates; Gastrointestinal Hemorrhage; Guaiac; Humans; Iron; Occult Blood; Toxicology

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Ferrous Compounds; Iron; Maleates

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Ferrous Compounds; Maleates

Topics: Anemia; Anemia, Hypochromic; Ascorbic Acid; Ferrous Compounds; Fumarates; Hematologic Diseases; Humans; Iron

Topics: Anemia; Anemia, Hypochromic; Ferrous Compounds; Fumarates; Iron; Maleates

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Ferrous Compounds; Hematologic Diseases; Iron; Maleates

Topics: Anemia; Anemia, Hypochromic; Anemia, Iron-Deficiency; Child; Ferrous Compounds; Humans; Infant; Iron

Topics: Anemia; Anemia, Hypochromic; Ferrous Compounds; Iron; Iron, Dietary

Topics: Anemia; Anemia, Hypochromic; Female; Ferrous Compounds; Gastrointestinal Hemorrhage; Gastrointestinal Tract; Hemorrhage; Humans; Iron; Menorrhagia; Metrorrhagia; Neoplasms; Pancreatic Neoplasms

Topics: Anemia; Ferrous Compounds; Iron; Maleates; Sodium Chloride, Dietary

Topics: Anemia; Ferrous Compounds; Humans; Nutritional Sciences; Vitamins; Yeasts