Abstract
Article history: Received on: 29/10/2014 Revised on: 12/12/2014 Accepted on: 21/01/2015 Available online: 28/03/2015 Objective: To compare the efficacy and safety of different oral and parenteral iron preparations in patients with anemia. Methods: An observational, prospective study in patients of anemia in pregnancy and chronic kidney disease (CKD) receiving iron sucrose, oral ferrous ascorbate and ferrous sulfate were included. Demographic details, clinical history, baseline hemoglobin, anemia indices data were recorded in a case record form. The patients were followed up monthly for 12 weeks and observed for clinical and haematological improvement and adverse drug reactions (ADRs). The data was analyzed using paired t-test, unpaired t-test and Fisher`s exact test. Results: Out of 232 patients, 84 received iron sucrose, 62 ferrous ascorbate and 86 ferrous sulfate. Oral and parenteral iron preparations significantly (P<0.0001) improved mean hemoglobin, anemia indices and serum ferritin at the end of study. However, mean increase in hemoglobin and anemia indices were significant (P<0.0001) with iron sucrose (4.42 ± 0.17gms/dL) as compared to ferrous ascorbate (3.45 ± 0.1) and sulfate (3.3 ± 0.4). Increase in serum ferritin was more and rapid (at 4 weeks) with iron sucrose as compared to ferrous ascorbate in CKD patients. Surprisingly, ADRs were more in patients treated with oral ferrous sulfate (86%) and ascorbate (71%) compared to iron sucrose (63%). Conclusion: Parenteral iron sucrose improves hemoglobin. anemia indices and replenish iron stores rapidly and is well tolerated than oral iron preparations.
Highlights
Anemia is a sign, not a disease of dynamic process
adverse drug reactions (ADRs) were more in patients treated with oral ferrous sulfate (86%) and ascorbate (71%) compared to iron sucrose (63%)
Patients of anaemia in pregnancy and chronic kidney disease (CKD) of more than 16 years and either gender treated with iron sucrose, oral ferrous ascorbate and ferrous sulphate, from November 2011 to January 2013 were enrolled in the study
Summary
The World Health Organization (WHO) defines anemia as hemoglobin (Hb) below 13 g/dL for adult males and postmenopausal women, and below 12 g/dL for premenopausal women (WHO, 1968). According to WHO, two billion people (>30% of the world's population) are anemic, mainly due to iron deficiency. The incidence of iron deficiency anemia (IDA) in India is 60% (urban) and 69% (rural) population (WHO India, 2006). It is the commonest medical disorder in pregnancy and in chronic kidney diseases (Adamson, 2011). Data on the efficacy and safety of theses preparations is scare. The present study was conducted to evaluate efficacy and safety of ferrous ascorbate and iron sucrose in patients with iron deficiency anemia
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