teferrol and Anemia

Acute post-partum anaemia can be associated with significant morbidity including a predisposition for postnatal depression. Lack of clear practice guidelines means a number of women are treated with multiple blood transfusions. Intravenous iron has the potential to limit the need for multiple blood transfusions but its role in the post-partum setting is unclear.. IIBAPPA is a multi-centre randomised non-inferiority trial. Women with a primary post-partum haemorrhage (PPH) >1000 mL and resultant haemoglobin (Hb) 5.5-8.0 g/dL after resuscitation with ongoing symptomatic anaemia who are otherwise stable (no active bleeding) are eligible to participate. Patients with sepsis or conditions necessitating rapid Hb restoration are excluded. Eligible participants are randomised to receive a blood transfusion or a single dose of intravenous iron polymaltose calculated using the Ganzoni formula. Primary outcome measures include Hb, Ferritin and C-Reactive Protein levels on Day 7. Secondary outcomes evaluate (i) Hb, Ferritin and CRP levels on Day 14, 28, (ii) anaemia symptoms on Day 0, 7, 14 and 28 using structured health related quality of life questionnaires, (iii) treatment safety by assessing adverse reactions and infection endpoints and (iv) the quantitative impact of anaemia on breast feeding quality using a hospital designed questionnaire.. If equivalence in Hb and ferritin levels, symptom scores and safety endpoints is demonstrated, intravenous iron may become the preferred treatment for women with acute post-partum anaemia to minimise transfusion reactions and costs.. Australian and New Zealand Clinical Trials Registry: ACTRN12615001370594 on 16th December, 2015 (prospective approval).

Topics: Administration, Intravenous; Adolescent; Adult; Anemia; Blood Transfusion; C-Reactive Protein; Female; Ferric Compounds; Ferritins; Hematinics; Hemoglobins; Humans; Middle Aged; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Prospective Studies; Quality of Life; Research Design; Symptom Assessment; Young Adult

Concern exists about the safety of iron supplementation given to individuals in malarious areas. The possible unfavourable impact of iron supplementation on malaria might be less when slow-release iron compounds are used instead of ferrous salts, because no toxic non-transferrin bound iron is formed. The aim of this study was to determine the effect of iron supplementation using the slow-release iron compound iron polymaltose (IPM) on the acquisition of malarial parasitaemia.. A randomized, placebo-controlled trial was performed in schoolchildren aged 5-18 years with mild or moderate anaemia on the Indonesian island Flores. Microscopic malaria-negative children were randomized to receive 8 weeks of IPM (6 mg elemental iron/kg/day) or placebo . The primary outcomes were the occurrence of microscopically detectable malarial parasitaemia at week 4, 8, 12 and 16 after start of treatment and the proportion of participants with real-time (RT) PCR positive malarial parasitaemia at week 16.. 294 Children were assigned to the IPM group and 297 to the placebo group. Whereas IPM supplementation failed to increased haemoglobin or ferritin concentrations, the IPM group had a significantly higher rate of occurrence of microscopically detectable parasitaemia [hazard ratio 2.2, 95% C.I. 1.2-4.0; P = 0.01]. This higher rate was confined to iron-replete children. At the end of the study, 89% of the children in the IPM group had remained free from microscopically detectable parasitaemia vs 95% of children in the placebo group. The proportion of plasmodial RT-PCR positive children was similar in both groups at week 16 (IPM group 16.6% vs placebo group 14.3%; P = 0.47). When analysis was restricted to iron-replete children (serum ferritin ≥30 µg/l), there was a trend for a higher proportion being RT-PCR positive at week 16 in the IPM group compared with the placebo group (20 vs 13.3%; P = 0.07). Erythrocyte microcytosis was an independent risk factor for microscopically detectable malarial parasitaemia.. A short course of IPM should be used cautiously in anaemic children in malaria endemic areas, as it has limited efficacy in treating iron deficiency, while it increases the rate of microscopic malarial parasitaemia in those with replete iron stores. Trial registration ISRCTN 83091970. Registered 16 May 2012 (retrospectively registered).

Topics: Adolescent; Anemia; Child; Child, Preschool; Dietary Supplements; Erythrocyte Indices; Female; Ferric Compounds; Hemoglobins; Humans; Incidence; Indonesia; Malaria; Male; Parasitemia; Risk

Anaemia and iron deficiency are common complications following post-bariatric abdominoplasty. Given the low oral absorbability of iron resulting from bariatric surgery, it has been hypothesised that postoperative intravenously administered iron supplementation could be used to treat anaemia and to prevent the development of iron deficiency in these patients.. In this multicentre open-label randomised clinical trial, 56 adult women undergoing post-bariatric anchor-line abdominoplasty will be allocated at a ratio of 1:1 for postoperative supplementation with two intravenously administered applications of 200 mg of iron saccharate or postoperative supplementation with 100 mg of iron polymaltose complex administered orally, twice a day for 8 weeks. The primary outcome is the difference in mean haemoglobin levels between the two groups at eight postoperative weeks. Secondary outcomes evaluated at one, four and eight postoperative weeks include iron profile, reticulocyte count, overall quality of life measured using the Short-Form 36 Health Survey (SF-36) questionnaire, fatigue measured using the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), adverse effects and postoperative complications.. This randomised clinical trial aims to evaluate the haematopoietic effectiveness of intravenously administered iron supplementation in patients undergoing post-bariatric abdominoplasty. A more effective recovery of haemoglobin levels could help improve the patients' quality of life and could provide an improved haematological status in preparation for the subsequent and frequent plastic surgeries these patients undergo.. Clinicaltrials.gov Identifier: NCT01857011 (8 May 2013), Universal Trial Number U111-1169-6223, Brazilian Clinical Trials Registry (REBEC): RBR-2JGRKQ .

Topics: Abdominoplasty; Administration, Intravenous; Administration, Oral; Adolescent; Adult; Anemia; Bariatric Surgery; Biomarkers; Brazil; Clinical Protocols; Drug Administration Schedule; Female; Ferric Compounds; Ferric Oxide, Saccharated; Glucaric Acid; Hematinics; Hematopoiesis; Hemoglobins; Humans; Middle Aged; Quality of Life; Research Design; Surveys and Questionnaires; Time Factors; Treatment Outcome; Young Adult

Topics: Anemia; Clinical Trials as Topic; Female; Ferric Compounds; Hematinics; Hemoglobins; Humans; Iron; Maltose; Polysaccharides; Pregnancy; Pregnancy Complications, Hematologic; Time Factors

Parenteral iron is integral in the treatment of anaemia of chronic kidney disease patients on haemodialysis (HD). However, increased liver iron concentration (LIC) can result from such treatment, and this correlates poorly with serum ferritin or transferrin saturation values. It is unclear whether increased cardiac iron concentration also occurs in this setting. We aimed to evaluate the relationship of intravenous iron supplementation to hepatic and cardiac iron deposition in chronic HD subjects.. A cohort of 10 patients on chronic HD for at least 1 year underwent MRI-based quantitation of hepatic and cardiac iron content to evaluate the relationship between intravenous iron supplements and hepatic and cardiac iron deposition. The results were compared against the cumulative parenteral iron dose and serum iron markers.. The median age was 61 years (95% confidence interval (CI) 50-71), HD time 2.5 years (95%CI 2.0-5.3) and cumulative iron dose 4300 mg (95%CI 2110-9045). Hepatic iron concentration was elevated in eight of 10 subjects (median 46 mmol/kg, range 31-76). Cardiac iron levels were within the reference range in all subjects. There was poor correlation between conventional haematinic values and either LIC or cardiac iron levels. None of the study subjects exhibited elevated cardiac iron concentration.. Whilst HD patients receiving standard parenteral iron therapy have elevated LICs, this is not associated with cardiac iron deposition. Transferrin saturation and serum ferritin levels are poor markers of either liver or cardiac iron deposition in HD subjects.

Topics: Administration, Intravenous; Aged; Anemia; Biomarkers; Female; Ferric Compounds; Ferritins; Hematinics; Humans; Liver; Magnetic Resonance Imaging; Male; Middle Aged; Myocardium; Pilot Projects; Renal Dialysis; Renal Insufficiency, Chronic; Time Factors; Tissue Distribution; Transferrin; Treatment Outcome

Hemomine (HM) is an herbal mixture consisting of 5 varieties of the hematopoietic herbal extracts (Angelica gigas Nakai, Cnidium officinale Makino, Paeonia lactiflora Pall., Rehmannia glutinosa Liboschitz ex Stueudel, Glycyrrhiza uralensis Fischer).. Anemia has been treated with iron supplements, whereas it could cause adverse side effects such as digestive discomfort. In the present study, HM was applied to SHA rats to test for several activities so as to verify its therapeutic potentials on anemia and digestive discomfort.. Sprague-Dawley rats were assigned to seven groups: (Two controls, two references (ferric hydroxide polymatose (FM) and ferritin extract glycerin hydrate (FA)), three different concentrations of HM, n=8 per groups), and induced subacute hemorrhagic anemia (SHA) through blood exsanguinations once a day for 7 days.. The SHA animal model showed changes in the markers related to classic iron-deficient and regenerative anemia in this experiment. However, the SHA related anemic signs were dose-dependently inhibited by the administration of HM 2, 1, and 0.5ml/kg for 7 days, and more favorably than the equal dosages of FM and FA. In addition, FM and FA showed the typical constipation signs, including reduction of in thickness of the colonic mucosa, in contrast, HM 2, 1, and 0.5ml/kg groups had no effects on the gastrointestinal motilities and the colonic mucous components when compared to the controls. The results suggested that the HM significantly showed to have therapeutic effects in the experimental SHA in rats, and is more potent than the commercial iron supplement through the proliferation of hematopoietic stem cells with reduced digestive discomfort.. Therefore, Hemomine may prove to be a promising hematopoietic and therapeutic agent for anemia.

Topics: Anemia; Animals; Disease Models, Animal; Dose-Response Relationship, Drug; Ferric Compounds; Ferritins; Hematinics; Hemorrhage; Male; Plant Extracts; Plants, Medicinal; Rats; Rats, Sprague-Dawley

To study the feasibility of iron and folic acid (IFA) supplementation among tribal adolescent girls and identify factors associated with high compliance.. Intervention study with IFA supplementation among tribal adolescent girls of Bijadandi block, Mandla district, Madhya Pradesh, India. Girls (n 274) from twelve villages randomly selected out of 100 potential villages received daily tablets containing iron (iii) hydroxide polymaltose complex equivalent to 100 mg of elemental Fe and 350 μg of folic acid (commercially available as Feritas tablets, marketed by Intas Pharmaceutical Ltd, India). IFA was given for 100 d and supervised by school teachers and anganwadi workers. Compliance was measured using cards and interviews.. Community-based iron supplementation programme.. Tribal adolescent girls aged 12-19 years.. In total 233 girls completed the study. Prevalence of anaemia was reduced from 94 % at baseline to 69 % after the intervention. Compliance rate (>80 tablets) was 89 %. Minor side-effects were reported by three girls, yet they consumed >80 tablets. Factors associated with compliance included fasting during the local festival (χ 2 = 72·74, df 3; P < 0·0001) and counselling (χ 2 = 72·74, df 3; P < 0·0001). Other qualitative factors like social mobilization, timely supply of tablets, quality of tablets (blister pack) and availability of teachers and anganwadi workers were also associated with the compliance and feasibility.. High compliance indicates that IFA supplementation with tablets is feasible among the tribal adolescent girls of Bijadandi block, Mandla district.

Topics: Adolescent; Adult; Anemia; Child; Counseling; Dietary Supplements; Fasting; Female; Ferric Compounds; Folic Acid; Holidays; Humans; India; Interviews as Topic; Iron; Iron, Dietary; Patient Compliance; Program Evaluation; Young Adult

The ageing population in developed countries, including Australia, is putting increasing demands on blood transfusion services. With a falling donor pool there is likely to be a shortage of blood and blood products in the next 20 to 30 years unless there are significant changes in medical practice. The National Health and Medical Research Council/Australasian Society of Blood Transfusion Clinical Practice Guidelines on the Use of Blood Components from 2001 are being redeveloped by the National Health and Medical Research Council/Australian and New Zealand Society of Blood Transfusion as evidence-based patient-focused Patient Blood Management guidelines with the aim of improving patient outcomes by reducing inappropriate blood and blood product use and targeting therapies for improving the management of anaemia and coagulopathies.

Topics: Aged; Anemia; Australia; Blood Banks; Blood Transfusion; Costs and Cost Analysis; Critical Care; Disease Management; Evidence-Based Practice; Ferric Compounds; Hematologic Diseases; Humans; Inappropriate Prescribing; Models, Theoretical; Patient-Centered Care; Perioperative Care; Plasma; Platelet Transfusion; Population Dynamics; Practice Guidelines as Topic; Prescriptions

Topics: Anemia; Female; Ferric Compounds; Hematinics; Humans; Pregnancy; Pregnancy Complications

Pharmacokinetic measurements of ferrous sulphate and ferric hydroxide-polymaltose complex on anaemic and non-anaemic rats have shown different postabsorption serum iron levels, invasion and elimination constants and distribution volumes for the two preparations. But nevertheless the absorption and utilization ratios of iron from both preparations are equal. It is therefore not justified to calculate utilization ratios for chemically different iron preparations on the basis of postabsorption serum iron measurements. Similar pharmacokinetic differences of these two iron preparations could also be found in clinical trials, which means that different serum iron increase results in an equal utilization ratio for both preparations. It is clear that ferrous sulphate and ferric hydroxide-polymaltose complex must have a different absorption mechanism. The postulated absorption mechanism is in agreement with all the facts known today and does explain the pharmacokinetic difference between the investigated preparations.

Topics: Anemia; Animals; Ferric Compounds; Ferrous Compounds; Intestinal Absorption; Iron; Kinetics; Male; Models, Biological; Rats

Topics: Anemia; Ferric Compounds; Humans; Iron; Maltose

Topics: Anemia; Ferric Compounds; Humans; Iron