teferrol and Anemia--Iron-Deficiency

Various therapeutic iron preparations are available in the market, which differ in their pharmacokinetic and safety profiles. There is insufficient evidence regarding the superior safety or efficacy of one over the other.. To study the effects of iron preparations on various parameters like hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and serum ferritin.. A systematic review and meta-analysis of randomized controlled trials (RCT) was conducted from inception till 3 June, 2022.. Databases like MEDLINE and COCHRANE were searched for RCTs evaluating the effects and safety profile of various iron salts in the management of iron deficiency anemia in children and adolescents.. Eight studies with a total of 495 children were included the review. Pooled analysis showed ferrous sulphate to cause a significant increase in hemoglobin compared with other iron compounds [mean difference (95% CI) 0.53 (0.22 to 0.83; P <0.001]. Also ferrous sulphate is superior to iron polymaltose complex (IPC) (P<0.001). However, there was a significant increase in gastrointestinal adverse effects with ferrous sulphate compared to IPC (P=0.03). Other iron compounds were more efficacious than IPC in raising hemoglobin levels (P<0.001). Among the few studies evaluating iron indices like MCV, MCH, and serum ferritin, there was no significant difference between the iron preparations (P>0.05).. A low quality evidence suggests that ferrous sulphate is more efficacious than other compounds (P<0.001); though, there is an increase in gastrointestinal side effects with ferrous sulphate.

Topics: Adolescent; Anemia, Iron-Deficiency; Child; Ferritins; Hemoglobins; Humans; Infant; Iron; Iron Compounds

Inflammatory bowel disease affects approximately seven million people globally. Iron deficiency anaemia can occur as a common systemic manifestation, with a prevalence of up to 90%, which can significantly affect quality of life, both during periods of active disease or in remission. It is important that iron deficiency anaemia is treated effectively and not be assumed to be a normal finding of inflammatory bowel disease. The various routes of iron administration, doses and preparations present varying advantages and disadvantages, and a significant proportion of people experience adverse effects with current therapies. Currently, no consensus has been reached amongst physicians as to which treatment path is most beneficial.. The primary objective was to evaluate the efficacy and safety of the interventions for the treatment of iron deficiency anaemia in people with inflammatory bowel disease.. We searched CENTRAL, MEDLINE, Embase, and two other databases on 21st November 2019. We also contacted experts in the field and searched references of trials for any additional trials.. Randomised controlled trials investigating the effectiveness and safety of iron administration interventions compared to other iron administration interventions or placebo in the treatment of iron deficiency anaemia in inflammatory bowel disease. We considered both adults and children, with studies reporting outcomes of clinical, endoscopic, histologic or surgical remission as defined by study authors.. Two review authors independently conducted data extraction and 'Risk of bias' assessment of included studies. We expressed dichotomous and continuous outcomes as risk ratios and mean differences with 95% confidence intervals. We assessed the certainty of the evidence using the GRADE methodology.. We included 11 studies (1670 randomised participants) that met the inclusion criteria. The studies compared intravenous iron sucrose vs oral iron sulphate (2 studies); oral iron sulphate vs oral iron hydroxide polymaltose complex (1 study); oral iron fumarate vs intravenous iron sucrose (1 study); intravenous ferric carboxymaltose vs intravenous iron sucrose (1 study); erythropoietin injection + intravenous iron sucrose vs intravenous iron sucrose + injection placebo (1 study); oral ferric maltol vs oral placebo (1 study); oral ferric maltol vs intravenous ferric carboxymaltose (1 study); intravenous ferric carboxymaltose vs oral iron sulphate (1 study); intravenous iron isomaltoside vs oral iron sulphate (1 study); erythropoietin injection vs oral placebo (1 study). All studies compared participants with CD and UC together, as well as considering a range of disease activity states. The primary outcome of number of responders, when defined, was stated to be an increase in haemoglobin of 20 g/L in all but two studies in which an increase in 10g/L was used. In one study comparing intravenous ferric carboxymaltose and intravenous iron sucrose, moderate-certainty evidence was found that intravenous ferric carboxymaltose was probably superior to intravenous iron sucrose, although there were responders in both groups (150/244 versus 118/239, RR 1.25, 95% CI 1.06 to 1.46, number needed to treat for an additional beneficial outcome (NNTB) = 9). In one study comparing oral ferric maltol to placebo, there was low-certainty evidence of superiority of the iron (36/64 versus 0/64, RR 73.00, 95% CI 4.58 to 1164.36). There were no other direct comparisons that found any difference in the primary outcomes, although certainty was low and very low for all outcomes, due to imprecision from sparse data and risk of bias varying between moderate and high risk. The reporting of secondary outcomes was inconsistent. The most common was the occurrence of serious adverse events or those requiring withdrawal of therapy. In no comparisons was there a difference seen between any of the intervention agents being studied, although the certainty was very low for all comparisons made, due to risk of bias and significant imprecision due to the low numbers of events. Time to remission, histological and biochemical outcomes were sparsely reported in the studies. None of the other secondary outcomes were reported in any of the studies. An analysis of all intravenous iron preparations to all o. Intravenous ferric carboxymaltose probably leads to more people having resolution of IDA (iron deficiency anaemia) than intravenous iron sucrose. Oral ferric maltol may lead to more people having resolution of IDA than placebo. We are unable to draw conclusions on which of the other treatments is most effective in IDA with IBD (inflammatory bowel disease) due to low numbers of studies in each comparison area and clinical heterogeneity within the studies. Therefore, there are no other conclusions regarding the treatments that can be made and certainty of all findings are low or very low. Overall, intravenous iron delivery probably leads to greater response in patients compared with oral iron, with a NNTB (number needed to treat) of 11. Whilst no serious adverse events were specifically elicited with any of the treatments studied, the numbers of reported events were low and the certainty of these findings very low for all comparisons, so no conclusions can be drawn. There may be more withdrawals due to such events when oral is compared with intravenous iron delivery. Other outcomes were poorly reported and once again no conclusions can be made as to the impact of IDA on any of these outcomes. Given the widespread use of many of these treatments in practice and the only guideline that exists recommending the use of intravenous iron in favour of oral iron, research to investigate this key issue is clearly needed. Considering the current ongoing trials identified in this review, these are more focussed on the impact in specific patient groups (young people) or on other symptoms (such as fatigue). Therefore, there is a need for studies to be performed to fill this evidence gap.

Topics: Adolescent; Adult; Aged; Anemia, Iron-Deficiency; Bias; Colitis, Ulcerative; Crohn Disease; Disaccharides; Erythropoietin; Ferric Compounds; Ferric Oxide, Saccharated; Fumarates; Hematinics; Humans; Iron Compounds; Maltose; Middle Aged; Placebos; Pyrones; Randomized Controlled Trials as Topic; Young Adult

Intravenous (IV) iron in pregnancy is useful where oral iron is not tolerated or a rapid replenishment of iron is required.. To review the literature on the efficacy and safety of different IV iron preparations in the management of antenatal iron-deficiency anaemia (IDA).. We searched MEDLINE, Embase and Scopus from inception to June 2016. Eligible studies were randomised controlled trials (RCTs) and observational studies, involving administration of IV iron (ferric carboxymaltose (FCM), iron polymaltose (IPM) or iron sucrose (IS)), regardless of comparator, to manage antenatal IDA. Two independent reviewers selected studies, extracted data and assessed quality.. A total of 47 studies were eligible (21 RCTs and 26 observational studies), investigating IS (n = 2635; 41 studies), FCM (n = 276; four studies) and IPM (n = 164; three studies). All IV preparations resulted in significant improvements in haematological parameters, with a median increase of 21.8 g/L at 3-4 weeks and 30.1 g/L by delivery, but there was no evidence of any associated improvements in clinical outcomes. A greater median increase in Hb was observed with a high (25 g/L; range: 20-39.6 g/L) compared with low dose (20 g/L; range: 6.2-50.3 g/L). The median prevalence of adverse drug reactions for IPM (2.2%; range: 0-4.5%) was lower than FCM (5.0%; range: 0-20%) and IS (6.7%; range: 0-19.5%).. While IV iron in pregnancy improves haematological parameters, there is an absence of evidence for improvements in important maternal or perinatal outcomes. No single preparation of IV iron appeared to be superior, with the current IV iron preparation of choice largely determined by cost and convenience around administration.

Topics: Administration, Intravenous; Anemia, Iron-Deficiency; Female; Ferric Compounds; Ferric Oxide, Saccharated; Humans; Maltose; Pregnancy; Pregnancy Complications, Hematologic; Quality of Life

Iron deficiency is one of the most common nutritional deficiencies in Australia, and remains one of the most underdiagnosed conditions in general practice. The consequences of this condition can be subtle and the cause is often multifactorial.. The aim of this article is to review the safety of parenteral iron replacement therapy, and specifically intravenous infusion, in the general practice setting. The results of a recent clinical evaluation of 43 consecutive adult patients are reported.. Intravenous iron polymaltose infusions are commonly used in the hospital setting with low rates of reported adverse reactions (including low rates of anaphylaxis and anaphylactoid reactions). In a primary care setting, patients were given low dose intravenous iron polymaltose as a slow injection diluted with normal saline, following a diagnosis of iron deficiency or iron depletion, with or without anaemia. Injections were given at intervals no more frequently than weekly. Serum ferritin levels were monitored following treatment, and as routine follow up. A total of 89 injections of intravenous iron were used in 43 patients. No serious adverse reactions occurred. The administration of low dose parenteral iron polymaltose in the primary care setting is well tolerated and is potentially a cost effective alternative to specialist care and hospital admissions.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Australia; Confidence Intervals; Female; Ferric Compounds; General Practitioners; Hematinics; Humans; Iron, Dietary; Male; Middle Aged; Primary Health Care; Young Adult

Iron(III)-hydroxide polymaltose complex (IPC) is an iron preparation with non-ionic iron and polymaltose in a stable complex. The usefulness of IPC in the treatment of iron deficiency anemia (IDA) has recently been a topic of much debate. By reviewing the published literature an overview is provided of the existing comparative evidence vs. ferrous sulfate as reference. For this purpose the standard methods and criteria as described by the Cochrane group are employed. The aim was to establish whether there are differences concerning efficacy (primary end-point: hemoglobin after approx. 2 months of treatment) and concerning safety (number of patients with adverse drug reactions [ADRs]). From an initial group of 14 comparative trials identified, 6 comparative studies (1 double blind) conducted in adults could be retained for analysis. Four pediatric studies initially selected had to be rejected because of heterogeneity of data at baseline. In adults (319 IPC, 238 ferrous sulfate) at the end of the study period (8-13 weeks) the mean hemoglobin values were 12.13 +/- 1.19 g/dl with IPC vs. 11.94 +/- 1.84 g/dl with ferrous sulfate (weighted mean difference WMD = 0.01 [95% CI -0.23, 0.21] g/dl). Not all studies reported on ferremia (higher with IPC), transferrin saturation (no difference) or ferritin (lower with IPC). Adverse drug reactions were reported less frequently with IPC (14.9%) than with ferrous sulfate (34.1%; p < 0.001), particularly upper digestive troubles, stained teeth and diarrhea. The meta-analysis of studies conducted in adult patients with iron deficiency anemia, comparing IPC with ferrous sulfate in equivalent doses, showed that the two compounds attained similar hemoglobin levels, thus suggesting similar efficacy. The tolerance of IPC in adults was clearly better than that of ferrous sulfate; the differences were also significant for the individual adverse reactions. This probably reflects a better risk/benefit ratio of IPC in adults. Properly conducted randomized controlled trials, particularly in pediatrics, are needed.

Topics: Adult; Anemia, Iron-Deficiency; Dietary Supplements; Endpoint Determination; Ferric Compounds; Ferrous Compounds; Humans; Randomized Controlled Trials as Topic; Risk Assessment

The following review of iron(III)-hydroxide polymaltose complex (IPC, Maltofer) shows that iron is significantly bioavailable after oral administration, especially in iron-deficient subjects. Numerous clinical trials in men, women, children and infants have shown that IPC is effective in treating iron deficiency anaemia (IDA). Due to its kinetic properties, IPC is best given with meals, and probably in an iron dose slightly higher than that of the classical iron salts. In terms of acceptance and patient compliance, IPC presents a clear advantage over ferrous salts. Many studies have shown a lower rate of treatment interruption with IPC than with ferrous salts. This is usually associated with a lower incidence of adverse events related to the upper gastro intestinal tract.

Topics: Anemia, Iron-Deficiency; Child, Preschool; Clinical Trials as Topic; Dietary Supplements; Drug Interactions; Female; Ferric Compounds; Ferrous Compounds; Folic Acid; Hemoglobins; Humans; Infant; Male; Patient Compliance; Randomized Controlled Trials as Topic

Absolute and functional iron deficiency is the most common cause of epoetin (recombinant human erythropoietin) hyporesponsiveness in renal failure patients. Diagnostic procedures for determining iron deficiency include measurement of serum iron levels, serum ferritin levels, saturation of transferrin and percentage of hypochromic red blood cells. Patients with iron deficiency should receive supplemental iron, either orally or intravenously. Adequate intravenous iron supplementation allows reduction of epoetin dosage by approximately 40%. Intravenous iron supplementation is recommended for all patients undergoing haemodialysis and for pre-dialysis and peritoneal dialysis patients with severe iron deficiency. During the maintenance phase (period of epoetin therapy after correction of iron deficiency), the use of low-dose intravenous iron supplementation (10 to 20 mg per haemodialysis treatment or 100 mg every second week) avoids iron overtreatment and minimises potential adverse effects. Depending on the degree of pre-existing iron deficiency, markedly higher iron doses are necessary during the correction phase (period of epoetin therapy after correction of iron deficiency) [e.g. intravenous iron 40 to 100 mg per haemodialysis session up to a total dose of 1000 mg]. The iron status should be monitored monthly during the correction phase and every 3 months during the maintenance phase to avoid overtreatment with intravenous iron.

Topics: Anemia, Iron-Deficiency; Citric Acid; Drug Combinations; Drug Monitoring; Erythropoietin; Ferric Compounds; Ferric Oxide, Saccharated; Ferrous Compounds; Glucaric Acid; Humans; Infusions, Intravenous; Injections, Intravenous; Iron Compounds; Iron Overload; Iron-Dextran Complex; Kidney Failure, Chronic; Sorbitol

Iron-deficiency anaemia (IDA) is a common nutritional deficiency among pregnant women in India. It has a significant impact on the health of the mother as well as that of the foetus. IDA generally responds well to treatment with oral iron supplementation. However, oral iron supplements are toxic to the gastrointestinal mucosa and intolerance is common, resulting in poor compliance and failure of treatment. The iron salts such as iron hydroxide polymaltose complex (IPC) and ferrous ascorbate (FeA) are claimed to have low gastrointestinal intolerance, therefore better patient compliance than the conventionally used ferrous sulphate (FS). These preparations also claim to increase haemoglobin level faster as well as improve the iron storage better than FS. This study was done to compare the efficacy and safety of FS with IPC and FeA.. It was a randomized, parallel, open label, study among pregnant women of gestational age between 12 to 26 wk with moderate anaemia. Patients were randomly allocated to receive either FS, IPC or FeA. They were then followed up for 90 days to observe for improvement in the haemoglobin levels and other haematological parameters or any adverse drug reaction.. The haemoglobin levels were comparable in the three groups except at day 90 when FeA group had significantly higher haemoglobin level as compared to FS group (P<0.05). The overall adverse effect profiles were also comparable among the study groups except epigastric pain which was more commonly reported in the FS group.. The results of the study showed that FS, IPC and FeA have comparable efficacy and safety profile in the treatment of IDA of pregnancy.

Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Ascorbic Acid; Child; Female; Ferric Compounds; Ferrous Compounds; Humans; Pregnancy; Pregnant Women; Young Adult

Iron deficiency anemia (IDA) is common among children with cerebral palsy (CP), and studies on the efficacy of lactoferrin (Lf) in the treatment of IDA are limited. This study aimed to compare the efficacy of Lf with that of iron hydroxide polymaltose complex (IPC) in the treatment of IDA in children with CP. This randomized controlled study, conducted at Alexandria University Children's Hospital, enrolled 70 children aged 1-10 years with CP and IDA; 35 children randomly received IPC, whereas the other 35 received Lf. Four children withdrew from the study; thus, only 66 children were analyzed (32 in the IPC group and 34 in the Lf group). At baseline, the hemoglobin level and other blood parameters were similar between the two intervention groups. After four weeks of treatment, both the IPC and Lf groups showed significant improvements in hemoglobin (Hb), serum ferritin (SF), serum iron, total iron-binding capacity, mean corpuscular volume, and mean corpuscular hemoglobin from baseline. Upon comparing the two treatment groups, adjusted mean Hb and SF changes in the Lf group were significantly higher than that of the IPC group (p =0.001and p= 0.033, respectively), and constipation was less likely to occur in the Lf group than the IPC group (p = 0.049 ).Conclusion: Lactoferrin is effective and superior to IPC as an oral iron replacement therapy in children with CP and IDA, as it has fewer side effects. What is Known: • Lactoferrin (LF) is a natural glycoprotein capable of treating iron deficiency anemia (IDA). • Studies on the efficacy of Lf in the treatment of IDA in children with cerebral palsy (CP) are limited. What is New? • This trial compared the efficacy of Lf and iron hydroxide polymaltose complex (IPC) as treatments of IDA in children with CP. • Lf is effective and even better than IPC as a treatment of IDA in children with CP, as it has fewer side effects.

Topics: Anemia, Iron-Deficiency; Cerebral Palsy; Child; Ferric Compounds; Hemoglobins; Humans; Lactoferrin

To compare the therapeutic efficacy of Ferrous ascorbate (FA) and Iron polymaltose complex (IPC) in Iron deficiency anemia (IDA) in children.. A randomized controlled trial (RCT) was conducted at a tertiary care hospital with 125 (1-12 y) children having clinical symptoms and signs of IDA. Participants were randomized into FA group and IPC group. Both the groups received iron salts (FA or IPC) randomly in a dose of 6 mg/kg elemental iron for 3 mo and followed up on day 3, day 7, at the end of 1 mo and 3 mo for Hemoglobin (Hb), Mean corpuscular volume (MCV), Red cell distribution width (RDW) and reticulocyte count.. Both groups had an improvement in hematological parameters at 3 mo of intervention. The difference in the rise of Hb (g%) at the end of 1 mo in FA group (3.13 ± 1.01) vs. IPC group (2.0 ± 0.85); p = 0.017 and at 3 mo in FA group (4.88 ± 1.28) vs. IPC group (3.33 ± 1.33); p = 0.001 was statistically significant. The difference in the rise of mean Hb was significantly better in FA than the IPC group F [3392] =1.79; p = 0.00 (ANOVA). The difference in the mean increase in MCV (fL) at day 7 in FA group (6.71 ± 8.32) vs. IPC group (2.91 ± 6.16); p = 0.011 and at 1 mo FA group (9.80 ± 8.56) vs. IPC group (5.35 ± 6.11); p = 0.004 was statistically significant. The mean decrease in RDW (%) at 1 mo in FA group (4.23 ± 3.27) vs. IPC group (2.67 ± 1.95); p = 0.005 and at 3 mo in FA group (5.74 ± 3.63) vs. IPC group (4.04 ± 2.17); p = 0.006 was statistically significant. The difference in the rise in mean reticulocyte count at day 3 in FA group (0.88 ± 0.50) vs. IPC group (0.43 ± 1.20); p = 0.017 and at day 7 in FA group (4.00 ± 1.69) vs. IPC group (2.19 ± 1.24); p = 0.001 was statistically significant. F [2294] = 29.2, p = 0.00 (ANOVA). During the study period, the FA group had minor adverse reactions whereas the IPC group had none.. Both the iron salts (FA and IPC) used in the treatment of IDA showed statistically significant improvement in the hematological parameters during the 3 mo of intervention. The improvement in hematological parameters was better in FA supplemented patients as compared to IPC.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Child; Child, Preschool; Dietary Supplements; Drug Combinations; Erythrocyte Indices; Female; Ferric Compounds; Hemoglobins; Humans; Infant; Iron; Iron Compounds; Male; Reticulocyte Count; Time Factors

Topics: Administration, Oral; Aged; Anemia, Iron-Deficiency; Chronic Disease; Dietary Supplements; Female; Ferric Compounds; Ferrous Compounds; Follow-Up Studies; Heart Failure; Hematinics; Hospitalization; Humans; Male; Prognosis; Prospective Studies; Time Factors; Trace Elements

The purpose of this study was to compare the effectiveness of different oral iron preparations in children with iron deficiency anemia (IDA).. Sixty children with IDA, aged between 6 months and 180 months, were randomly assigned into three treatment groups. Group I included children with IDA who received ferrous sulfate (Fe-S); Group II included children receiving iron polymaltose complexes (Fe-OH-PM), and Group III included children receiving a single preparation of combined iron and zinc (Fe-Zn). The effect of different iron preparations were evaluated and compared. The duration of treatment was 8 weeks. Hemoglobin (Hgb) levels, as well as other hematological parameters were determined at admission and the first, fourth, and eighth weeks of the treatment.. The Hgb levels of patients in all three groups were statistically higher in the fourth (P=0.001) and eighth (P<0.001) weeks compared to baseline; although there was no difference between the groups at the end of the treatment period (P>0.05).. Our results indicate that, Fe-OH-PM and Fe-Zn preparations may also be preferred as a choice like Fe-S for treatment of children with IDA.

Topics: Administration, Oral; Adolescent; Anemia, Iron-Deficiency; Child; Child, Preschool; Female; Ferric Compounds; Ferrous Compounds; Hematinics; Hemoglobins; Humans; Infant; Male; Treatment Outcome; Zinc

Iron Deficiency Anemia (IDA) is a major public health problem worldwide. Iron Bisglycinate Chelate (FeBC) and polymaltose iron (FeP) are used for the treatment of IDA and exhibit good tolerability with a low incidence of adverse effects. However, these compounds have important differences in their structures and bioavailability.. To compare the efficacy of oral supplementation with FeBC and FeP in anemic children.. In this double-blind study, children aged 1 to 13 years who were diagnosed with IDA were randomly divided into two groups: i) FeBC, supplemented with iron bisglycinate chelate, and ii) FeP, supplemented with polymaltose iron (3.0 mg iron/kg body weight/day for 45 days for both groups).. Both treatments resulted in significant increases in hemoglobin levels, Mean Corpuscular Volume (MCV) and Cell Distribution Width (RDW) and in a reduction of transferrin levels, relative to initial values. However, only FeBC treatment significantly increased ferritin and Mean Corpuscular Hemoglobin (MCH) levels. A significant negative correlation was observed between the increase in ferritin and initial hemoglobin levels in the FeBC group, indicating that the absorption of FeBC is regulated by the body iron demand.. These results provide preliminary evidence to suggest a greater efficacy of FeBC than FeP in increasing iron stores.

Topics: Adolescent; Anemia, Iron-Deficiency; Child; Child, Preschool; Dietary Supplements; Double-Blind Method; Erythrocyte Indices; Ferric Compounds; Ferritins; Hematinics; Hemoglobins; Humans; Infant; Iron; Pilot Projects; Transferrin; Treatment Outcome

Iron deficiency anaemia (IDA) is the most common nutritional deficiency affecting pregnant women worldwide. This study aims to compare the efficacy and safety of a newly available intravenous (IV) iron preparation, ferric carboxymaltose (FCM), against IV iron polymaltose (IPM), and standard oral iron (ferrous sulphate) for the treatment of IDA in pregnancy. This is an open-labelled prospective randomised controlled trial (RCT) with intention-to-treat analysis conducted at a primary health care facility with a single tertiary referral centre in Launceston. Tasmania, Australia. A 3-arm randomised controlled trial was conducted comparing a single IV infusion of 1000mg of FCM (n = 83 patients) over 15 minutes against a single IV infusion of 1000mg of IPM (n = 82) over 2 hours against 325mg daily oral ferrous sulphate (n = 81) until delivery, for the treatment of IDA in pregnancy. A total of 246 consecutive pregnant women were recruited between September 2013 and July 2014. The median age was 28 years, with a median and mean gestation of 27 weeks. The median serum ferritin was 9µg/L, with a mean of 13µg/L. The mean haemoglobin (Hb) was 114g/L. The primary outcome was the change in ferritin and Hb levels at 4 weeks after intervention. Secondary outcomes included ferritin and Hb improvements at predelivery, safety, tolerability, quality of life (QoL), cost utility, and fetal outcomes. The mean Hb level differences between the baseline intervention time point and 4 weeks thereafter were significantly higher in the FCM versus the oral group by 4.35g/L (95% CI: 1.64-7.05; P = 0.0006) and in the IPM vs the oral group by 4.08g/L (95% CI: 1.57-6.60; P = 0.0005), but not different between the FCM and IPM groups (0.26g/L; 95% CI: -2.59 to 3.11; P = 0.9740). The mean ferritin level differences were significantly higher at 4 weeks in the FCM vs oral iron group by 166µg/L (95% CI: 138-194; P < 0.0001) and in the IPM vs oral iron group by 145µg/L (95% CI: 109-1180, P < 0.0001), but not between the 2 IV groups (21.5µg/L; 95% CI: -23.9 to 66.9; P = 0.4989). Administration of IV FCM during pregnancy was safe and better tolerated than IV IPM or oral iron. Compliance to oral iron was the lowest amongst treatment groups with one-third of the patients missing doses of daily iron tablets. Significant improvement in overall QoL scores was observed in both IV iron supplement groups by achieving normal ferritin following effective and prompt repletion of iron stores, compared to the o

Topics: Administration, Oral; Adolescent; Adult; Anemia, Iron-Deficiency; Female; Ferric Compounds; Ferrous Compounds; Humans; Infusions, Intravenous; Maltose; Middle Aged; Pregnancy; Prospective Studies; Young Adult

The purpose of this study was to compare the total oxidant and antioxidant effect of different oral iron preparations in children with iron-deficiency anemia (IDA).. A total of 65 children with IDA were randomized to receive 5 mg Fe/kg/d iron (II) sulfate (Fe(2+) group, n=33) or iron (III)-hydroxide polymaltose complex (Fe(3+) group, n=32); healthy controls (n=28) were also included in the study. Serum total thiol (-SH), total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), and hematological profile were evaluated at the baseline and on day 8 and day 30 of the therapy.. Serum TOS and OSI levels were significantly higher and total -SH and total antioxidant capacity levels were significantly lower in the study groups at the beginning of therapy than in the controls (P>0.001). In multivariate analysis, after controlling for multiple confounding factors, on days 8 and 30, serum TOS and OSI levels were not different in the Fe(3+) group, whereas they were significantly reduced in the Fe(2+) group (P≤0.033).. Serum total oxidant status was significantly increased in children with IDA, and Fe(2+) was highly effective in correcting elevated oxidative status.

Topics: Anemia, Iron-Deficiency; Antioxidants; Child; Child, Preschool; Delayed-Action Preparations; Female; Ferric Compounds; Ferrous Compounds; Hematinics; Humans; Male; Oxidants; Oxidation-Reduction; Oxidative Stress; Treatment Outcome

The effects of iron deficiency anemia (IDA) and its treatment on plasma total antioxidant capacity (TAOC) were investigated.. Sixty patients with IDA and 20 healthy controls were divided into four subgroups: an oral (per os: PO) group (n = 20); an intramuscular (IM) group (n = 20); an intravenous (IV) group (n = 20); and the control group (n = 20). Blood samples were obtained from all patients before treatment, and at 24 h, 7 days, 6 and 13 weeks after initiation of IDA therapy.. TAOC in the IDA group was low when compared with the control group (P < 0.001). Although TAOC at 24 h in the PO group was not different from the control group, the TAOC in the IM and IV groups was relatively lower (P < 0.001). The TAOC in the PO group at 7 days, and at 6 and 13 weeks was closest to the control group level. The mean TAOC in the IV group at 13 weeks was clearly lower relative to the PO and IM groups.. Oxidative stress was minimally induced with oral therapy, while IM and IV therapies induced higher levels of oxidative stress, in increasing order of intensity.

Topics: Administration, Oral; Adolescent; Anemia, Iron-Deficiency; Antioxidants; Child; Child, Preschool; Developing Countries; Dose-Response Relationship, Drug; Female; Ferric Compounds; Ferric Oxide, Saccharated; Ferrous Compounds; Glucaric Acid; Glycine; Hemoglobinometry; Humans; Infant; Infusions, Intravenous; Injections, Intramuscular; Male; Oxidative Stress; Sucrose; Turkey

To evaluate the efficacy and safety of iron(III) polymaltose complex (Maltofer(®)) versus ferrous sulfate in iron-deficient pregnant women using recommended doses.. An exploratory, open-label, randomized, controlled, multicenter study was undertaken in 80 pregnant women with iron-deficiency anemia (hemoglobin ≤ 10.5 g/dL, serum ferritin ≤ 15 ng/mL and mean corpuscular volume < 80 fL). Patients were randomized 1:1 to oral iron(III) polymaltose complex or ferrous sulfate (each 100 mg iron twice daily) for 90 days.. The primary endpoint, change in hemoglobin from baseline to days 60 and 90, did not differ significantly between treatment groups. The mean (SD) change to day 90 was 2.16 (0.67) g/dL in the iron(III) polymaltose complex group and 1.93 (0.97) g/dL in the ferrous sulfate group (n.s). Mean serum ferritin at day 90 was 179 (38) ng/mL and 157 (34) ng/mL with iron(III) polymaltose complex and ferrous sulfate, respectively (p = 0.014). Adverse events were significantly less frequent in the iron(III) polymaltose group, occurring in 12/41 (29.3%) patients, than in the ferrous sulfate group (22/39 [56.4%]) (p = 0.015).. Oral iron(III) polymaltose complex offers at least equivalent efficacy and a superior safety profile compared to ferrous sulfate for the treatment of iron-deficiency anemia during pregnancy.

Topics: Adult; Anemia, Iron-Deficiency; Erythrocyte Indices; Female; Ferric Compounds; Ferritins; Ferrous Compounds; Gestational Age; Hematocrit; Hemoglobins; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome

Iron deficiency anaemia is the most common deficiency disorder in the world, affecting more than one billion people, with pregnant women at particular risk.. We conducted a single site, prospective, nonblinded randomized-controlled trial to compare the efficacy, safety, tolerability and compliance of standard oral daily iron versus intravenous iron.. We prospectively screened 2654 pregnant women between March 2007 and January 2009 with a full blood count and iron studies, of which 461 (18%) had moderate IDA. Two hundred women matched for haemoglobin concentration and serum ferritin level were recruited.. Patients were randomized to daily oral ferrous sulphate 250 mg (elemental iron 80 mg) with or without a single intravenous iron polymaltose infusion.. Prior to delivery, the intravenous plus oral iron arm was superior to the oral iron only arm as measured by the increase in haemoglobin level (mean of 19.5 g/L vs. 12 g/L; P < 0.001); the increase in mean serum ferritin level (222 microg/L vs. 18 ug/L; P < 0.001); and the percentage of mothers with ferritin levels below 30 microg/L (4.5% vs. 79%; P < 0.001). A single dose of intravenous iron polymaltose was well tolerated without significant side effects.. Our data indicate that intravenous iron polymaltose is safe and leads to improved efficacy and iron stores compared to oral iron alone in pregnancy-related IDA.

Topics: Administration, Oral; Adult; Anemia, Iron-Deficiency; Birth Weight; Drug Therapy, Combination; Female; Ferric Compounds; Ferritins; Ferrous Compounds; Hematinics; Hemoglobins; Humans; Infant, Newborn; Infusions, Intravenous; Patient Compliance; Pregnancy; Pregnancy Complications, Hematologic; Prospective Studies; Quality of Life; Young Adult

We prospectively compared the efficacy and safety of iron deficiency anemia prophylaxis with iron gluconate (IG) or iron polymaltose complex (IPC) in healthy infants attending a community pediatric center. Participants were randomly assigned to receive one of the test drugs from age 4 to 6 months to age 12 months. Parents/guardians were given extensive information on iron-rich diets and anemia prevention. Main outcome measures were blood levels of hemoglobin, hematocrit, mean corpuscular volume, red blood cell distribution width, and serum iron, ferritin, and transferrin, in addition to adverse effects. One hundred five children completed the study: 53 in the IG group and 52 in the IPC group Mean hemoglobin levels at study end were significantly higher in the IG group (12.04±0.09 g/dL vs. 11.68±0.11, P<0.014). A hemoglobin level <11 g/dL was detected in 3 infants of the IG group, and in 10 infants of the IPC group (P<0.04). Adverse effects (spitting, vomiting, diarrhea, constipation, discolored teeth) were significantly more common in the IG group (47% vs. 25%, P>0.025). In conclusion, both oral IG and IPC prevent iron deficiency anemia in infants. Iron gluconate seems to be more effective but less tolerable.

Topics: Anemia, Iron-Deficiency; Erythrocyte Indices; Female; Ferric Compounds; Ferritins; Ferrous Compounds; Hematinics; Hematocrit; Hemoglobins; Humans; Infant; Infant, Newborn; Iron; Male; Prospective Studies; Transferrin

We assessed the clinical response and side effects of Ferrous sulfate (FS) and Iron polymaltose complex (IPC) in 118 children with Iron deficiency anemia (IDA). Subjects were randomized to receive therapy with either oral IPC (Group A, n=59) or oral FS (Group B, n=59); all were given elemental iron in three divided doses of 6 mg/kg/day. One hundred and six children could be followed up; 53 in each group. Children who received ferrous sulfate were having higher hemoglobin level, and less residual complaints as compared to those who had received iron polymaltose complex. Our study suggests ferrous sulfate has a better clinical response and less significant adverse effects during treatment of IDA in children.

Topics: Anemia, Iron-Deficiency; Child; Child, Preschool; Female; Ferric Compounds; Ferrous Compounds; Hemoglobins; Humans; Infant; Male

The efficacy of iron polymaltose complex (IPC) in the treatment of iron deficiency anemia (IDA) during pregnancy has not been well established, and the evidence is inconclusive.. The aim of the study was to compare efficacy, safety, compliance, and cost-effectiveness of IPC with ferrous sulphate (FS) in pregnant patients.. The randomized, double-blind, parallel-group study was conducted in the Department of Pharmacology in collaboration with the Department of Obstetrics and Gynaecology Postgraduate Institute of Medical Education and Research, Chandigarh, India.. One hundred pregnant women aged 20-40 years at 14 to 27 weeks' gestation, with hemoglobin (Hb) < 9 g/dL, and serum ferritin < 12 mcg/L, were classified into 2 groups. One group received IPC (100 mg elemental iron), and the other group received FS (120 mg elemental iron) daily for 8 weeks. At Week 0 and Week 8, Hb, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum iron, and serum ferritin were measured. Compliance with study medication was determined by pill counting at each visit. Cost minimization analysis was done to compare the costs of the 2 treatments.. Data are expressed as mean -/+ SD. Paired and unpaired 't' test were used to analyze differences within groups and between groups. Chi-square (x2) test was used to analyze primary efficacy parameters and adverse drug reactions (ADR).. Statistically significant increases in Hb, PCV, MCV, MCH, MCHC, serum iron, and serum ferritin levels were seen at the end of 8 weeks of treatment in both groups. The overall adverse effects were more common in the FS group compared with the IPC group [41 (78%) vs 15 (31%), P < .001]. The compliance rate was significantly (P < .05) higher for the IPC (91%) group than for the FS (87%) group. The average total cost (direct + indirect) of treatment of anemia was comparable between the 2 groups.. The results of the present study suggest that IPC can be considered as a useful alternative formulation for the treatment of IDA during pregnancy for those patients who cannot tolerate other iron preparations (ferrous form); this is an important finding, as compliance is a significant concern during pregnancy.

Topics: Adult; Anemia, Iron-Deficiency; Cost-Benefit Analysis; Double-Blind Method; Female; Ferric Compounds; Ferrous Compounds; Humans; Pregnancy; Pregnancy Complications, Hematologic

The study was carried out as an open-label, but laboratory-blind, single-dose, single-centre, randomized, two-period crossover study. Twenty-two patients with iron deficiency anemia completed the study. The study consisted of two treatment phases of 36 h, separated by a washout period of between 6 and 14 days. The two treatments were given orally. The reference treatment was tetracycline (CAS 60-54-8) alone (2 x 250 mg capsules) and the test treatment was iron(III)-hydroxide polymaltose complex (IPC, Maltofer) together with tetracycline (2 x 250 mg capsules). IPC had no pharmacokinetic effect on the rate of absorption of tetracycline. With concomitant administration of tetracycline and IPC sufficiently high tetracycline concentrations, to ensure bacteriostasis, will be reached. An inhibitor effect of IPC to the tetracycline absorption, as it is known for ferrous salts, could not be observed.

Topics: Adult; Algorithms; Anemia, Iron-Deficiency; Anti-Bacterial Agents; Area Under Curve; Drug Interactions; Female; Ferric Compounds; Half-Life; Humans; Intestinal Absorption; Male; Middle Aged; Quality Control; Sample Size; Single-Blind Method; Tetracycline

The study was carried out as an open-label, laboratory-blind, single-dose, randomized, two-period crossover, isotope efficacy study. Twenty-two patients with iron-deficiency anemia were enrolled in the study. The study consisted of two treatment phases of 15 days each, including blood sample measurements for Fe-59 activity. The 2 treatments were given orally. Treatment A was Fe-59 labeled iron(III)-hydroxide polymaltose complex (IPC, Maltofer), equivalent to 100 mg elemental iron given orally, and Treatment B consisted of Treatment A combined with 600 mg aluminium hydroxide (CAS 21645-51-2) (10 ml). No differences between the two treatment groups with regard to the erythrocyte uptake were found, and thus IPC can be used with aluminium hydroxide, if necessary.

Topics: Adolescent; Adult; Algorithms; Aluminum Hydroxide; Anemia, Iron-Deficiency; Animals; Antacids; Area Under Curve; Biological Availability; Chemical Phenomena; Chemistry, Physical; Dietary Supplements; Double-Blind Method; Erythrocytes; Female; Ferric Compounds; Ferritins; Humans; Intestinal Absorption; Iron; Iron Radioisotopes; Male; Mice; Middle Aged; Quality Control; Rats

The study was carried out as an open-label, laboratory-blind, single-dose, randomized, two-period crossover, isotope efficacy study. Twenty-two patients with iron-deficiency anemia were enrolled in the study. The study consisted of two treatment phases of 15 days each, including blood sample measurements for Fe-59 activity. The two treatments were given orally. Treatment A was Fe-59 labeled iron(III)-hydroxide polymaltose complex (IPC, Maltofer) equivalent to 100 mg elemental iron given orally. Treatment B consisted of Fe-59 labeled IPC complex equivalent to 100 mg elemental iron and 500 mg tetracycline HCl (CAS 64-75-5) given orally. No differences between the two treatment groups with regard to the erythrocyte iron uptake were found, and thus IPC can be used with tetracycline, if necessary.

Topics: Adult; Anemia, Iron-Deficiency; Anti-Bacterial Agents; Chemical Phenomena; Chemistry, Physical; Cross-Over Studies; Dietary Supplements; Drug Interactions; Erythrocyte Indices; Erythrocytes; Female; Ferric Compounds; Ferritins; Hemoglobins; Humans; Iron; Iron Chelating Agents; Iron Radioisotopes; Male; Middle Aged; Prospective Studies; Quality Control; Sample Size; Single-Blind Method; Tetracycline

A primary objective of the study was to evaluate how food as well as a specific enhancer or an inhibitor of iron uptake affect erythrocyte iron uptake after oral administration of iron(III)-hydroxide polymaltose complex (IPC, Maltofer) in subjects with or without iron deficiency. Secondary objectives of the study were 1. to compare the uptake of 59Fe in erythrocytes between subjects with or without iron deficiency, 2. to evaluate the 59Fe activity in plasma after oral administration of IPC and 3. to evaluate the safety of oral administration of IPC by adverse events (AEs), vital signs, and hematological and clinical chemistry parameters.. Single-centre study with a crossover design. Each subject participated in two periods where single doses of 100 mg iron as IPC labeled with 59Fe were administered. In one period the subjects were fasting and in the other they were fed (Group A and Group B). Alternatively the study medication was administered in the fed state with an iron absorption enhancer (orange juice) or an iron absorption inhibitor (black tea, Group C and Group D). Eight subjects were included in each group, i.e. 32 subjects were included in total. All subjects completed the study and were included in the analyses of data.. In terms of relative incorporation of iron in erythrocytes, both subjects with and without iron deficiency benefited from the concomitant administration of an enhancer with the IPC. In iron deficiency subjects the iron uptake was improved when administered with food whereas for the normal subjects the uptake was greater during fasting conditions. The uptake of 59Fe in erythrocytes was greater in subjects with iron deficiency compared to the normal subjects, except when IPC was administered during fasting conditions. The safety assessments performed in this study did not demonstrate any unexpected observations or safety concerns with IPC.. In both subjects with and without iron deficiency treated with IPC the relative iron incorporation in erythrocytes increased in case of a concomitant administration of an enhancer. Furthermore, the 59Fe uptake in erythrocytes was higher in subjects with iron deficiency compared to normal subjects, except when IPC was administered during fasting conditions.

Topics: Adult; Anemia, Iron-Deficiency; Beverages; Citrus sinensis; Cross-Over Studies; Data Interpretation, Statistical; Erythrocytes; Female; Ferric Compounds; Food-Drug Interactions; Hemoglobins; Humans; Iron; Iron Radioisotopes; Male; Tea; Transferrin

Treatment of iron deficiency anaemia with conventional oral preparations is handicapped by unpredictable haematological response in addition to potential for irritating gastrointestinal adverse events. Iron polymaltose complex (IPC), a novel oral iron formulation with better absorbability, predictable haematinic response and less side effects was compared with oral ferrous fumarate in 100 female patients with documented iron deficiency anaemia. Clinical parameters (pallor, weakness) as well as biochemical parameters (Hb, serum iron, total iron binding capacity) show favourable changes with IPC; the physician and patient assessment also favour IPC over ferrous fumarate.

Topics: Adult; Anemia, Iron-Deficiency; Developing Countries; Drug Combinations; Female; Ferric Compounds; Ferrous Compounds; Folic Acid; Humans; Prospective Studies; Treatment Outcome

Topics: Administration, Oral; Adolescent; Adult; Anemia, Iron-Deficiency; Female; Ferric Compounds; Hematinics; Humans; India; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Treatment Outcome

The aim of this study was to compare two different doses and means of administration of iron in recombinant human erythropoietin (rHuEPO)-treated very low birth-weight (VLBW) infants. VLBW infants (n = 41) were randomized to one of three groups. Fourteen infants were treated with rHuEPO (300 IU/kg three times a week s.c.) and oral iron (ferrofumarate, 6 mg of iron/kg per day). Another 14 infants received the same erythropoietin dose and intramuscular iron (ferroxypolymaltose, once 12 mg of iron/kg weekly). Thirteen infants were treated with the same dose of intramuscular iron but did not receive rHuEPO. After the 3-week study period, haemoglobin concentrations and reticulocyte counts were similar in the rHuEPO-treated groups and both were higher than in the group not receiving rHuEPO (P < 0.001). In both rHuEPO-treated groups the transferrin receptor concentration increased from 6.8-7.2 mg/l to 10.5-11.3 mg/l.. In erythropoietin-treated very low birth weight infants the iron need for erythropoiesis can be met by oral administration of iron.

Topics: Administration, Oral; Anemia, Iron-Deficiency; Drug Therapy, Combination; Erythropoietin; Ferric Compounds; Ferrous Compounds; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Injections, Intramuscular; Iron; Recombinant Proteins; Regression Analysis; Statistics, Nonparametric; Time Factors

Anaemia is the most common medical disorder in pregnancy with iron deficiency anaemia accounting for the majority of cases. Over 90% of the iron deficiency anaemia is due to red cell iron deficiency associated with depleted iron stores and deficient intake. The two main modalities of treating iron deficiency anaemia are oral or parenteral iron. Ferrous Hausmann (iron dextrin) is the latest iron preparation which can be used for intravenous parenteral administration as a total dose infusion. This study compares the efficacy of Ferrum Hausmann with oral ferrous fumarate therapy in the treatment of iron deficiency anaemia in pregnancy. Our study shows that treatment with intravenous Ferrum Hausmann (iron dextrin) resulted in a significantly better level and rate of increase of haemoglobin (p<0.001). Serum ferritin, which is the best indicator of iron stores, was significantly higher (p<0.001) in the intravenous group. Other indices of iron status such as serum iron, serum transferrin and zinc protoporphyrin also showed a significant improvement in the intravenous group compared to those given oral iron. The results suggest that intravenous iron as a total dose infusion is able to replenish iron stores more efficiently, completely and at a faster rate than oral iron therapy, thus providing the fuel for stimulation of full erythopoiesis compared to oral iron. There were also no reports of any adverse reactions with intravenous iron dextrin, whereas there were a considerable proportion of women on oral iron therapy who reported side effects. In conclusion, intravenous iron therapy with Ferrous Hausmann (iron dextrin) is a suitable, effective and safe alternative to oral iron therapy in the treatment of iron deficiency anaemia in pregnancy.

Topics: Administration, Oral; Adolescent; Adult; Anemia, Iron-Deficiency; Female; Ferric Compounds; Ferrous Compounds; Hematinics; Hemoglobins; Humans; Injections, Intravenous; Iron; Middle Aged; Pregnancy; Pregnancy Complications, Hematologic; Treatment Outcome

One-hundred children, 48 males and 52 females, mean age +/- SD 39.9 +/- 28.2 months (range 12 to 113) with sideropenia or sideropenic anemia were randomly divided into 2 groups of 50 patients each (groups A and B) and were treated with iron protein succinylate (group A) or iron hydroxide polymaltose complex (group B). Patients of both groups received 4 mg/kg elemental iron, maximally 80 mg daily, for 2 months. Side-effects of therapy and laboratory values (RBC, hematocrit, hemoglobin, MCV, serum iron, total iron binding capacity, and ferritin) were registered before treatment, 30 days after the beginning of therapy as well as after 60 days in order to evaluate tolerability and efficacy of the drugs. Both drugs were well tolerated and showed only few adverse reactions, which were comparable in severity and frequency. Iron protein succinylate led not only to a faster increase of hemoglobin, hematocrit, MCV, serum iron, and ferritin than iron hydroxide polymaltose complex, but the laboratory values remained higher in group A than in B even after 2 months of treatment.

Topics: Abdominal Pain; Anemia, Iron-Deficiency; Child; Child, Preschool; Diarrhea; Drug Tolerance; Erythrocyte Indices; Erythrocytes; Female; Ferric Compounds; Hematinics; Hematocrit; Hemoglobins; Humans; Infant; Male; Metalloproteins; Nausea; Succinates; Treatment Outcome; Vomiting

Background In Australia, iron deficiency anaemia can be managed by ferric carboxymaltose, and iron polymaltose given via either a traditional slow or new rapid infusion protocol. These differ in their manufacturing, administration, and monitoring requirements, with unknown associated costs. Aim To compare the direct costs of iron infusions used in Australia; and explore potential savings associated with increased uptake of the least-expensive option at a local hospital. Method A time-motion method was used to determine the labour and consumables associated with each infusion protocol. Secondly, a frequency analysis identified the most common iron infusion doses prescribed at the study site. The total direct costs per protocol were compared at these doses and then the potential savings from switching to the lowest-costing of these protocols where possible were explored. Results The most common doses were 0.5 g, 1 g, 1.5 g and 2 g. At these dose points, ferric carboxymaltose infusions are the least expensive, but only if national health subsidies are applied. In cases where they do not apply, iron polymaltose prepared from ampoules and infused using the rapid protocol ('Iron Polymaltose Ampoules Rapid') is the least expensive. Switching all applicable ferric carboxymaltose infusions and iron polymaltose infusions administered using the slow infusion protocol to Iron Polymaltose Ampoules Rapid is projected to yield up to $12,000 worth of savings annually. Conclusions Increased use of the Iron Polymaltose Ampoules Rapid protocol when government-subsidised options are not available is projected to have cost-saving outcomes. Investigation of implementation strategies to increase the use of this protocol are warranted.

Topics: Anemia, Iron-Deficiency; Ferric Compounds; Humans; Infusions, Intravenous; Maltose

Iron amino acid chelates have been developed to be used as food fortificants and therapeutic agents in the treatment of iron deficiency anemia.. To compare the efficacy of Oral iron bisglycinate chelate (FeBC), lactoferrin (LF), lactoferrin with iron and iron polymaltose complex (IPC) in treatment of iron deficiency anemia (IDA).. a comparative study was conducted on 120 children with IDA, they attended to outpatient clinic at Menoufia University Hospitals within a period from April to November 2019. All subjects were classified into FeBC Group (30 children received iron bisglycinate), LF Group (30 children received lactoferrin 100 mg), LF with iron Group (30 children received 30% iron saturated lactoferrin) and IPC Group (30 children received iron polymaltose complex with elemental iron of6 mg/kg/day). Serum iron, serum ferritin, transferrin saturation was investigated.. After treatment serum iron, serum ferritin and transferrin saturation improved in FeBC group than LF group, in LF with iron group than LF group, and in IPC group than LF group. Serum ferritin improved in LF with iron group than IPC group. Side effects of drugs were higher in FeBC group than LF group, and higher in LF with iron group than FeBC group.. Adding lactoferrin to iron helps increasing iron stores more than using iron alone in treatment of iron deficiency anemia. Lactoferrin is less effective than lactoferrin with iron, iron bisglycinate chelate and iron polymaltose complex in treatment of iron deficiency anemia.

Topics: Anemia, Iron-Deficiency; Child; Ferric Compounds; Humans; Iron; Iron Deficiencies; Lactoferrin

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Child; Ferric Compounds; Humans; Iron

Iron polymaltose infusions are one type of iron infusate used to treat iron deficiency used in countries such as Australia. We looked at the safety profile of this infusion at one metropolitan hospital in Melbourne, Australia and the associated demographics of those who had reactions.. A retrospective review of the medical records all adult patients who had an iron polymaltose infusion at Western Hospital over 12 months was performed. Basic demographics, infusion indication, starting hemoglobin and ferritin, vital signs and medical details of patients who had an adverse reaction were recorded.. There were 1103 patients who had iron infusions in a 12-month review period between 2017 and 2018. Adverse drug reactions occurred in 2.7% of infusions with no mortalities. The most common reaction was urticaria. No cases of anaphylaxis were recorded; however, four cases were associated with marked hypotension which resolved with fluid resuscitation and cessation of the infusion. Overall, vital signs remained clinically stable pre and post-iron polymaltose infusions.. Iron polymaltose has a low rate of adverse drug reactions; yet, serious side-effects such as hypotension may occur. Perturbations in hemodynamics within the first 20 min suggest close monitoring is necessary in the initial stages of infusion.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Australia; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Ferric Compounds; Humans; Infusions, Intravenous; Male; Maltose; Middle Aged; Retrospective Studies; Treatment Outcome; Young Adult

Topics: Anemia, Iron-Deficiency; Female; Ferric Compounds; Humans; Pregnancy

To examine the adverse drug reactions (ADRs) and the efficacy of intravenous iron polymaltose and ferric carboxymaltose (FCM) among gynecology/obstetric patients with anemia.. The present retrospective observational study examined data from anemic obstetrics and gynecology patients who received either iron polymaltose or FCM between January 1, 2011, and April 30, 2015, at The Royal Women's Hospital, Victoria, Australia. Patient demographic data, dosage, ADR documentation, and hemoglobin levels were collected from medical records and compared.. The study included 221 patients; 111 and 110 received iron polymaltose and FCM, respectively. ADRs were documented for 18 (16.2%) patients in the iron polymaltose group and 2 (1.8%) in the FCM group (P<0.001), with no incidences of anaphylaxis. Both formulations achieved increased hemoglobin levels within 12 weeks (P<0.001 for both). Mean hemoglobin level increases were similar in both groups among non-pregnant patients (P=0.186), but were greater in the iron polymaltose cohort among pregnant patients (P=0.005). FCM dose compliance was suboptimal, with 8 of 57 (14%) patients who required second visits for doses greater than 1000 mg returning for the infusion.. FCM was associated with a lower incidence of ADRs than iron polymaltose. Patients receiving FCM infusions were less likely to receive their total required iron dose. Further randomized prospective studies are required to compare clinical efficacy of iron polymaltose versus FCM.

Topics: Administration, Intravenous; Adolescent; Adult; Aged; Anemia, Iron-Deficiency; Australia; Cohort Studies; Female; Ferric Compounds; Humans; Maltose; Middle Aged; Pregnancy; Retrospective Studies; Treatment Outcome; Young Adult

Topics: Anemia, Iron-Deficiency; Female; Ferric Compounds; Humans; Iron; Pregnancy; Retrospective Studies

Intravenous iron is commonly utilised in pregnancy when treatment with oral is not tolerated or where rapid replenishment of iron stores is required.. To examine the relationship between doses of intravenous iron administered during pregnancy according to different maternal bodyweight measures and subsequent treatment response.. Retrospective cohort study of pregnant women with confirmed iron deficiency anaemia who received intravenous iron polymaltose at a tertiary teaching hospital in Australia from 1 January 2014 to 31 January 2016. Diagnosis of anaemia and/or iron deficiency, infusion dosage characteristics and haematological parameters were collected from paper-based case notes and electronic records. The dose of intravenous iron administered was examined relative to maternal total bodyweight (TBW), ideal bodyweight (IBW) (equation = 45.5 kg + 0.9 kg/cm for each cm over 152 cm) and adjusted bodyweight (equation = IBW + [0.4 × (TBW - IBW)]).. A total of 122 pregnancies was identified where women had confirmed iron deficiency anaemia and received a single infusion of intravenous iron polymaltose. Dose-response relationships were evident between change in haemoglobin from treatment until delivery and intravenous iron dose according to adjusted bodyweight (adjusted beta coefficient 0.70 (95% CI 0.24-1.15)) and pre-pregnancy total bodyweight (adjusted beta coefficient 0.83 (95% CI 0.36-1.29)), but not ideal bodyweight (adjusted beta coefficient 0.37 (95% CI -0.04-0.78)). Calculating iron deficit using adjusted bodyweight most closely matched that based on a physiological estimate of iron deficit according to weight-based total blood volume.. Optimal treatment outcomes in pregnant women requiring intravenous iron may be reached by dosing according to adjusted pre-pregnancy bodyweight rather than ideal bodyweight.

Topics: Adult; Anemia, Iron-Deficiency; Cohort Studies; Dose-Response Relationship, Drug; Female; Ferric Compounds; Humans; Infusions, Intravenous; Pregnancy; Pregnancy Complications, Hematologic; Retrospective Studies; Young Adult

We compared the efficacy of ferrous sulfate (divalent) and ferric polymaltose (trivalent) compounds for the prophylaxis of iron-deficiency anemia (IDA). Study infants included exclusively breast milk-fed term infants. Subjects were divided randomly into 2 groups at 4 months of age and group 1 (n=56) received divalent and group 2 (n=56) received trivalent iron (Fe) preparation at a dose of 2 mg/kg/d for 5 months. At 9 months of age, after a 5-month prophylaxis, a significant increase was observed in hemoglobin (Hb), hematocrit, serum Fe levels, and transferrin saturation in both groups. However, group 1 had significantly higher Hb, hematocrit, mean corpuscular volume, Fe, and transferrin saturation than group 2 (11.7±0.6 g/dL, 34.6%±1.7%, 76.2±2.9 fL, 55.5±1.8 mcg, 20.8±3.9 g/L, respectively in group 1 vs. 11.3±0.5 g/dL, 33.5%±1.5%, 74.7±3.2 fL, 42.5±1.8 mcg, 14.1±7.5 g/L, respectively in group 2). No significant difference was found in ferritin values between the groups. Fe deficiency was found in 17 (30.3%) of the subjects in group 1, and 23 (41%) of subjects in group 2 whereas 5 (8.9%) subjects had IDA in group 1 and 12 (12%) in group 2 which were insignificant between groups. No significant difference was found with regard to side effects between 2 Fe preparations. Although divalent Fe therapy led to a higher Hb and serum Fe level, both ferrous and ferric Fe preparations were effective for prophylactic use in the prevention of Fe deficiency and IDA with comparable side effects.

Topics: Anemia, Iron-Deficiency; Ferric Compounds; Ferritins; Ferrous Compounds; Hemoglobins; Humans; Infant; Premedication; Treatment Outcome

Iron and phosphate are both vital to many biological cellular processes with central roles in energy metabolism, cellular proliferation and nucleic acid synthesis. Regulatory pathways in some of these metabolic pathways may intersect at fibroblast growth factor 23 (FGF23), a major phosphate regulatory hormone. Iron is reported to induce hypophosphataemia in rare cases, and recent reports suggest that iron deficiency may upregulate FGF23 synthesis by mechanisms involving hypoxia-inducible factor 1α (HIF1α). Our objective was to evaluate the effect of administration of intravenous iron polymaltose on intact and c-terminal FGF23 (i:cFGF23) ratios in two independent cohorts of patients, iron-deficient but non-inflamed patients and haemodialysis (HD)-dependent patients, and to examine the balance of synthesis and degradation.. We studied biochemical effects of intravenous iron polymaltose on both iFGF23 and cFGF23 fragments and their ratios in two patient groups: iron-deficient patients with normal renal function (ID-norm) and HD patients receiving iron supplementation (HD-ESKD) at a single institution. Patients were tested at baseline, day 4 and day 12 post iron administration.. Parenteral iron polymaltose resulted in increased i:cFGF23 ratios in ID-norm patients where circulating cFGF23 levels decreased with no appreciable effect on iFGF23, whereas no significant changes in i:cFGF23 ratios were observed in HD-ESKD patients following intravenous administration of 100mg iron polymaltose.. Dysregulation of intracellular FGF23-processing mechanisms may be related to iron deficiency per se rather than iron repletion with iron polymaltose. In ID-norm, i:cFGF23 ratios altered with iron administration without significant clinical alterations in mineral parameters, implying that other regulatory mechanisms may be important. Finally, iron supplementation in HD-ESKD patients does not appear to significantly affect i:cFGF23 ratios already disturbed by a chronic inflammatory or functionally iron-deficient state.

Topics: Administration, Intravenous; Aged; Anemia, Iron-Deficiency; Dietary Supplements; Female; Ferric Compounds; Fibroblast Growth Factor-23; Fibroblast Growth Factors; Hematinics; Humans; Iron; Male; Middle Aged; Parenteral Nutrition; Renal Dialysis; Renal Insufficiency, Chronic; Treatment Outcome

Iron deficiency anemia is an important public health issue, especially for infants, children, and women with menorrhagia. Oral iron supplements are the cheapest, safest, and most effective treatment. This study compared the therapeutic and side effects of ferrous and ferric in iron deficiency anemia.. This was a retrospective study on data collected between April 2012 and October 2013 for patients with iron deficiency anemia who continuously took oral ferric for over one month and then switched to oral ferrous due to poor therapeutic effects. The exclusion criteria were the use of other oral or injected iron preparations, erythropoietin, or vitamin B12.. A total of 41 participants were recruited. The average participant age was 44.76±16.89 years; most participants were females (95.1%; 39/41); the average daily dose of oral ferric (139.02±49.39 mg) was higher than that of ferrous (96.34±23.43 mg). Repeated measures: mixed model analyses were conducted to examine patients' clinical blood test values. The results showed that the mean blood test values for all patients significantly increased after switching to ferrous (p<0.01, with the exception of mean corpuscular hemoglobin). One patient experienced gastrointestinal discomfort and diarrhea after switching to ferrous.. This study found that blood test values improved after iron deficiency anemia female patients who displayed poor therapeutic effects with oral ferric switched to ferrous. Literature review showed that the risk for gastrointestinal problems with ferrous is higher than that with ferric. However, no significant difference was found in this study.

Topics: Administration, Oral; Adult; Anemia, Iron-Deficiency; Citric Acid; Dietary Supplements; Female; Ferric Compounds; Ferrous Compounds; Hematinics; Hemoglobins; Humans; Male; Middle Aged; Retrospective Studies; Tablets; Taiwan; Treatment Outcome

Topics: Administration, Oral; Anemia, Iron-Deficiency; Cholecalciferol; Ferric Compounds; Humans; Inflammatory Bowel Diseases; Infusions, Intravenous; Injections, Intramuscular; Maltose; Vitamin D Deficiency

Iron is an important micronutrient, but it can also act as a dangerous element by interfering with glucose homeostasis and inflammation, two features that are already disturbed in obese subjects. In this work, we study the effects of systemic iron supplementation on metabolic and inflammatory responses in mice with hypoferremia induced by obesity to better characterize whether iron worsens the parameters that are already altered after 24 weeks of a high-fat diet (HFD). Mice were maintained on a control diet or a HFD for 24 weeks and received iron-III polymaltose (50 mg/kg/every 2 days) during the last two weeks. Glucose homeostasis (basal glucose and insulin test tolerance) and systemic and visceral adipose tissue (VAT) inflammation were assessed. Iron levels were measured in serum. The Prussian blue reaction was used in isolated macrophages to detect iron deposition. Iron supplementation resulted in an increased number of VAT macrophages that were positive for Prussian blue staining as well as increased serum iron levels. Systemic hepcidin, leptin, resistin, and monocyte chemoattractant protein-1 (MCP-1) levels were not altered by iron supplementation. Local adipose tissue inflammation was also not made worse by iron supplementation because the levels of hepcidin, MCP-1, leptin, and interleukin (IL)-6 were not altered. In contrast, iron supplementation resulted in an increased production of IL-10 by adipose tissue and VAT macrophages. Leukocytosis and VAT plasminogen activator inhibitor-1 (PAI-1) level were reduced, but insulin resistance was not altered after iron supplementation. In conclusion, systemic iron supplementation in mice with hypoferremia induced by obesity did not worsen inflammatory marker or adipose tissue inflammation or the metabolic status established by obesity. Iron deposition was observed in adipose tissue, mainly in macrophages, suggesting that these cells have mechanisms that promote iron incorporation without increasing the production of inflammatory mediators.

Topics: Anemia, Iron-Deficiency; Animals; Blood Glucose; Cytokines; Dietary Supplements; Ferric Compounds; Hepcidins; Inflammation; Intra-Abdominal Fat; Iron; Male; Mice; Obesity

Iron deficiency anaemia is a major public health problem in pregnancy. About 58% of pregnant women in developed countries are anaemic mainly due to iron deficiency resulting a serious negative consequences on children, mothers and eventually on the nation. This quasi-experimental multi centered study (Before after study) was done to evaluate the efficacy and tolerability of Iron Polymaltose Complex (IPC) in the treatment of iron deficiency anaemia and it was performed at the OPD of Bangladesh Medical College and two other clinics of Dhaka city from August 2011 to September 2013. A total of 80 (eighty) subjects were selected by purposive sampling as per inclusion and exclusion criteria. They were treated by Iron Polymaltose-IPC [47mg elemental iron + Folic Acid 0.5mg + Zinc 22.5mg - Once daily orally for 12 weeks]. At the beginning and after 12 weeks of intervention by Iron Polymaltose Complex (IPC) Hb%, Packed Cell Volume (PCV), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Serum iron, and Serum ferritin were measured. Data were analyzed by SPSS version 13.0. Paired and unpaired 't' test was used to analyze differences within groups and between groups. Chi-square test was done to analyze primary efficacy parameters and adverse drug reactions (ADR). Most of the respondents were within the age group of 18-23 and 30-35 years (32.6% each). Significant differences were found by treatment with IPC for 12 weeks in Hb%, PCV, MCV, MCH, Serum iron, and Serum ferritin level. In iron deficiency anaemia during pregnancy IPC may be used as a safe and cost-effective therapeutic management.

Topics: Anemia, Iron-Deficiency; Bangladesh; Erythrocyte Indices; Female; Ferric Compounds; Hemoglobins; Humans; Pregnancy; Pregnancy Complications, Hematologic

Although oral iron preparations are widely prescribed to prevent and to treat iron deficiency anemia in pregnancy, comparative data on their effects to the mother, fetus and placenta are limited. In this study, the effects of oral iron polymaltose complex (IPC), ferrous fumarate (FF) and ferrous sulfate (FS) were compared in anemic pregnant rats, their fetuses and placentas. Hematological variables and oxidative stress markers in the liver, heart and kidneys of the dams and fetuses as well as the markers for oxidative stress, inflammation and hypoxia in placentas were assessed. Pregnancy outcome was measured by number of fetuses, and by neonate and placental weight. All therapies were comparably effective in correcting anemia. FS and FF, but not IPC, resulted in liver damage in dams and oxidative stress in dams, fetuses and placentas. FS group presented the highest catalase and GPx levels in dams, fetuses and placentas. IPC, but not FF or FS, restored normal TNF-α and IL6 expression levels in placentas whereas FS-treated animals presented the highest cytokine levels, suggesting a local inflammatory reaction. Anemia-induced high levels of HIF-1α were partially lowered by IPC and FF but further elevated by FS. Most of the negative effects associated with IDA were resolved by IPC treatment. Especially FS treatment was found to elicit hepatic damage in the dams, oxidative stress in the dams, fetuses and placenta as well as inflammation and high levels of HIF-1α in the placenta. Pregnancy outcome of FFand FS-treated animals was worse than that of IPC-treated animals.

Topics: Administration, Oral; Anemia, Iron-Deficiency; Animals; Disease Models, Animal; Female; Ferric Compounds; Ferrous Compounds; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Inflammation Mediators; Interleukin-6; Oxidative Stress; Placenta; Pregnancy; Pregnancy Outcome; Rats, Sprague-Dawley; Tumor Necrosis Factor-alpha

Iron deficiency anemia (IDA) can severely impair the outcome of pregnancy. IDA has been shown to cause oxidative stress, which may be exacerbated by oral iron therapy. In this study, the effects of IDA and its treatment with iron polymaltose complex/folic acid (IPC/FA) were examined in anemic pregnant rats, their fetuses and placentas.. Hematological variables and oxidative stress markers in the liver, heart and kidney were evaluated in non-anemic, anemic and IPC/FA-treated pregnant rats and their fetuses. Markers for oxidative stress, inflammation and hypoxia were assessed in the placentas of all groups.. IDA was shown to increase oxidative stress levels in all the studied organs and in placenta as well as hypoxia and inflammation in placenta. IPC/FA treatment corrected IDA measured by the hemoglobin level, serum iron level and transferrin saturation. The oxidative stress levels in all the studied organs and in placentas of the IPC/FA-treated group were comparable to those of the non-anemic group. The number of fetuses and the neonatal and placental weight were lower in the anemic group compared to the non-anemic and IPC/FA-treated groups.. The current study shows that IDA in pregnant rats impaired pregnancy outcome, increased the expression of hypoxia and inflammatory markers in the placenta, and increased oxidative stress in dams, fetuses and placentas. Treatment with oral IPC/FA corrected the IDA as well as reduced the levels of oxidative stress and inflammatory markers close to non-anemic control values in all the studied organs.

Topics: Anemia, Iron-Deficiency; Animals; Female; Ferric Compounds; Glutathione; Hematinics; Male; Malondialdehyde; Oxidative Stress; Placenta; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Rats; Rats, Sprague-Dawley

Intravenous correction of iron deficiency by total dose iron polymaltose is inexpensive and safe, but current protocols entail prolonged administration over more than 4 h. This results in reduced patient acceptance, and hospital resource strain. We aimed to assess prospectively the safety of a rapid intravenous protocol and compare this with historical controls.. Consecutive patients in whom intravenous iron replacement was indicated were invited to have up to 1.5 g iron polymaltose by a 58-min infusion protocol after an initial 15-min test dose without pre-medication. Infusion-related adverse events (AE) and delayed AE over the ensuing 5 days were also prospectively documented and graded as mild, moderate or severe.. One hundred patients, 63 female, mean age 54 (range 18-85) years were studied. Thirty-four infusion-related AE to iron polymaltose occurred in a total of 24 patients--25 mild, 8 moderate and 1 severe; higher than previously reported for a slow protocol iron infusion. Thirty-one delayed AE occurred in 26 patients--26 mild, 3 moderate and 2 severe; similar to previously reported. All but five patients reported they would prefer iron replacement through the rapid protocol again. The presence of inflammatory bowel disease (IBD) predicted infusion-related reactions (54% vs 14% without IBD, P < 0.001) and the serum C-reactive protein was higher in those with reactions (P = 0.043).. Iron polymaltose can be successfully administered using a rapid total dose infusion protocol and was well accepted by patients. It offers significant cost, resource utilization and time benefits for the patient and hospital system.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Clinical Protocols; Female; Ferric Compounds; Humans; Inflammatory Bowel Diseases; Infusions, Intravenous; Male; Middle Aged; Polysaccharides; Prospective Studies; Time Factors; Young Adult

Haemoglobin mass in a female endurance athlete was measured via carbon monoxide rebreathing upon diagnosis of iron-deficiency anemia (haemoglobin concentration = 8.8 g/dL, ferritin = 9.9 ng/mL) and regularly during treatment thereafter. Haemoglobin mass increased by 49% in the 2 wk following an intramuscular iron injection and continued to increase with oral iron supplementation for 15 wk. The presented case illustrates that haemoglobin mass is readily responsive to iron supplementation in a severely iron-deficient anemic athlete and that changes can be tracked efficiently using the CO-rebreathing method.

Topics: Administration, Oral; Anemia, Iron-Deficiency; Biomarkers; Breath Tests; Drug Administration Schedule; Female; Ferric Compounds; Ferrous Compounds; Hematinics; Hemoglobins; Humans; Injections, Intramuscular; Physical Endurance; Running; Time Factors; Treatment Outcome; Young Adult

Many hemodialysis patients receive antiplatelet therapy or warfarin; however, little is known about the effect of this on iron requirements. Given the association of antiplatelet therapy with bleeding we hypothesized that there should be a greater need for iron in such patients, which we tested in this study.. Retrospective 1-year cohort study of 205 chronic hemodialysis patients. The primary outcome variable was total iron dose, which was analyzed according to antiplatelet/warfarin use. Data were also collected on potential confounders, allowing for both unadjusted and adjusted (multiple regression) analysis.. 97/205 patients received antiplatelet/warfarin therapy. This group was older, with a higher incidence of macrovascular disease and diabetes and a higher median C-reactive protein (6.0 vs. 3.75 mg/l). Overall, median iron requirement was 1,300 mg/year. In a multiple regression analysis, antiplatelet/warfarin use was associated with an additional iron requirement of 703 mg (95% confidence interval 188-1,220 mg), with the strongest effect observed in patients with normal inflammatory markers.. We found a high requirement for iron in patients receiving antiplatelet agents/warfarin. We argue that the most likely mechanism for this association is chronic, low-grade blood loss, although further study is required before causality can be established.

Topics: Age Factors; Aged; Anemia, Iron-Deficiency; C-Reactive Protein; Comorbidity; Diabetic Nephropathies; Female; Ferric Compounds; Ferritins; Hemorrhage; Humans; Inflammation; Iron; Iron Deficiencies; Kidney Failure, Chronic; Male; Middle Aged; Nutritional Requirements; Platelet Aggregation Inhibitors; Renal Dialysis; Retrospective Studies; Thrombophilia; Transferrin; Vascular Diseases; Warfarin

Two hundred and forty one patients with iron deficiency anemia (IDA) were identified in a single institution over a 24-year period; of these, 75 individuals were studied as the result of persistent IDA despite the administration of oral iron hydroxide polymatose (IP). The levels of hemoglobin when the patients were referred for study after being given oral IP had a median of 10.3 g/dl; after administration of oral iron fumarate during periods ranging from 1 to 14 months, the levels of hemoglobin rose to a median of 12.5 g/dl (p>0.01). Our data support previous observations made in other countries about the ineffectiveness of oral IP in the treatment of individuals with IDA and should alert the clinician to avoid unnecessary consultations and misdiagnosis.

Topics: Adolescent; Adult; Aged; Anemia, Iron-Deficiency; Child; Child, Preschool; Drug Evaluation; Female; Ferric Compounds; Hemoglobins; Humans; Infant; Male; Middle Aged; Treatment Failure

An anaphylactic reaction after intravenous Fe injection (Ferrum Hausmann) occurred in an 84-year-old female patient on treatment for iron deficiency anemia. After emergency admission to hospital, it emerged that she suffered an acute anteroseptal myocardial event, but could be mobilized without any problems on adequate cardiac medication. After ruling out any hyporegenerative pathology, the hemoglobin level of 101 g/L registered can probably be explained within the scope of mild renal insufficiency. Instead of the intravenous form of iron (III) sucrose (saccharate) complex (Ferrum Hausmann i.v. / Venofer), the attending general practitioner had administered parenteral iron replacement i.v. in the form of Ferrum Hausmann (iron (III) hydroxide dextran complex), which is intended for intramuscular administration. This is the reason why, firstly, the oral form of administration should be preferred over the parenteral and, secondly, parenteral replacement using the iron saccharate complex should be only initiated in the case of a pathological oral iron load test indicating an iron resorption disorder.

Topics: Aged; Aged, 80 and over; Anaphylaxis; Anemia, Iron-Deficiency; Drug Hypersensitivity; Female; Ferric Compounds; Hematinics; Humans; Infarction, Middle Cerebral Artery; Injections, Intravenous; Kidney Failure, Chronic; Myocardial Infarction

Topics: Adult; Anemia, Iron-Deficiency; Biopsy; Criminology; Drug Eruptions; Female; Ferric Compounds; Humans; Hyperpigmentation; Injections, Intramuscular; Male; Middle Aged; Minocycline; Rosacea; Silver Nitrate; Skin; Theft

Topics: Adult; Anemia, Iron-Deficiency; Female; Ferric Compounds; Humans; Treatment Failure

Topics: Anemia, Iron-Deficiency; Drug Costs; Ferric Compounds; Humans; India

Ironhydroxide polymaltose (IPC) preparations were used to treat four pregnant women with iron deficiency anemia. Despite patient compliance for sufficient length of time, hemoglobin failed to rise. By the time this was noticed, pregnancy was well advanced and delivery was only few weeks away. Patients were switched over to ferrous fumarate/succinate/parenteral iron. Although hemoglobin increased, women were still iron deficient at the time of delivery. Besides exposing women to hazards of iron deficiency at the time of delivery, their new borns are exposed to the risks intrauterine growth retardation and its consequences in childhood and later life. It would be advisable to avoid the use IPC preparations in patients with iron deficiency anemia, especially pregnant women.

Topics: Adult; Anemia, Iron-Deficiency; Female; Ferric Compounds; Hematinics; Humans; Pregnancy; Pregnancy Complications, Hematologic; Treatment Failure

Topics: Anemia, Iron-Deficiency; Aspirin; Coronary Artery Bypass; Ferric Compounds; Ferrous Compounds; Hemoglobinometry; Humans; Iatrogenic Disease; Male; Middle Aged; Postoperative Complications; Treatment Failure

Topics: Anemia, Iron-Deficiency; Female; Ferric Compounds; Humans; Pregnancy; Pregnancy Complications, Hematologic

Topics: Adult; Anemia, Iron-Deficiency; Drug Resistance; Female; Ferric Compounds; Hematinics; Humans; Injections, Intravenous; Pregnancy; Pregnancy Complications, Hematologic

To investigate whether there are differences in the frequency of ADRs (adverse drug reactions) to parenteral iron preparations, we compared the results of 4 different data collections which contain observations in particular on i.m. or i.v. iron dextran and i.v. iron hydroxide sucrose complex, primarily in relation to anaphylactic/anaphylactoid reactions and common exanthemas. 1. In 206 patients of the department of general internal medicine in a city/teaching hospital (in association with the Swiss Foundation for Comprehensive Hospital Drug Monitoring--CHDM), 4 probably allergic reactions to i.m. iron dextran were found, one with acute severe dyspnea, cyanosis and flush, 3 with slight generalized, probably allergic reactions. Data from the USA on i.v. iron dextran do not show marked differences in the frequency of ADRs as compared with our data with i.m. administration. 2. A group of 400 otherwise healthy patients of the obstetric department of Zurich University Hospital were treated with i.v. iron sucrose for anemia due to iron loss during pregnancy or following childbirth. Seven generalized skin reactions, 4 in the form of flush and 3 of common exanthema, occurred. 3. In a retrospective study on patients on maintenance hemodialysis with chronic renal insufficiency and anemia, a questionnaire was answered by the medical heads of 17 selected hemodialysis units in Switzerland. Response was 100%. During around 8100 patient-years with approximately 160,000 ampoules of iron sucrose (with 100 mg elementary iron), not a single life threatening reaction was observed; only 5-7 situations of rapidly reversible blood pressure fall occurred, some 10 with flush, and one each with urticaria and vomiting/diarrhea. 4. The relatively good tolerance of i.v. iron sucrose in patients with chronic renal failure may be due either to reduced immune competence in patients with chronic renal insufficiency and/or to the use of the preparation itself, or probably both. 5. In ADRs of allergic appearance to iron sucrose, the 7 generalized skin reactions occurred on the first day of the injections, as did those under iron dextran. Preexisting hypersensitivity must be taken into consideration. 6. If our experience is confirmed, preventive measures with i.v. iron sucrose, mainly in patients with chronic renal insufficiency, could be reduced.

Topics: Adult; Adverse Drug Reaction Reporting Systems; Aged; Anaphylaxis; Anemia, Iron-Deficiency; Drug Eruptions; Drug Hypersensitivity; Female; Ferric Compounds; Hematinics; Humans; Injections, Intramuscular; Injections, Intravenous; Iron-Dextran Complex; Male; Middle Aged; Pregnancy; Pregnancy Complications; Puerperal Disorders; Renal Dialysis; Risk Factors; Switzerland

Topics: Anemia, Iron-Deficiency; Blood Transfusion, Autologous; Combined Modality Therapy; Erythropoietin; Ferric Compounds; Hematinics; Humans; Infusions, Intravenous; Iron; Recombinant Proteins