Correction Of Iron Deficiency Research Articles

Correction of iron deficiency and iron deficiency anemia in women of reproductive age: choice of a drug within framework of concept of patient blood management

The article presents a review of the literature and our own data on the problem of prevention, diagnosis and treatment of iron deficiency and iron deficiency anemia in patients of reproductive age with a burdened somatic status with the development of a chronic inflammatory process. In the concept of patient blood management (PBM), the diagnosis and treatment of anemia in patients with gynecological diseases requiring subsequent surgical treatment is given paramount importance, since anemia and iron deficiency are considered risk factors for worse treatment outcomes for patients. Women with gynecological pathology often have diseases that are accompanied by the development of a systemic inflammatory response, which leads to activation of hepcidin protein synthesis and the development of so-called anemia of inflammatory diseases. Data are presented indicating the effectiveness and safety of the sucrosomial iron drug (SiderAL® Forte) in obstetric and gynecological patients with increased levels of C-reactive protein in combination with iron deficiency and iron deficiency anemia. The increase in ferrokinetic parameters in patients receiving sucrosomial iron is due to the unique physicochemical and pharmacokinetic characteristics of sucrosome, which provides protection of sucrosomial iron from the effects of gastric juice, excluding contact with the mucous membrane of the gastrointestinal tract and its absorption through special M-cells of the small intestinal mucosa followed by the release of iron in liver cells. Sucrosomial iron is novel, convenient, effective, and well tolerated compared with traditional oral iron supplements.

Effect of correcting iron deficiency on the risk of serious infection in heart failure: Insights from the IRONMAN trial.

Concerns exist that intravenous (IV) iron might increase the risk of infections. The IRONMAN trial provided an opportunity to investigate whether giving IV ferric derisomaltose (FDI) to patients with heart failure and iron deficiency alters the rate of hospitalization or death due to infections. IRONMAN was a randomized trial of IV FDI versus usual care in patients with symptomatic heart failure, left ventricular ejection fraction (LVEF) ≤45%, and transferrin saturation (TSAT) <20% or ferritin <100 μg/L. Infection was a pre-specified, blindly-adjudicated, safety endpoint. The primary analysis of interest was infection as the main reason for hospitalization or death, using first and recurrent events analyses. The composite primary event of interest tended to be lower in those randomized to FDI when analysed as first (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.62-1.01, p = 0.055) or recurrent event (rate ratio 0.85, 95% CI 0.64-1.13, p = 0.089). The composite results were driven by fewer hospitalizations for infection (HR 0.76, 95% CI 0.49-0.98, p = 0.032), with 5% fewer patients (absolute reduction) experiencing such an event if assigned to FDI. Similar trends were observed for recurrent events (HR 0.82, 95% CI 0.62-1.10). Further analyses suggested that the reduction in hospitalizations due to infection with FDI was restricted to patients with TSAT <20%. In patients with heart failure and a reduced LVEF, correction of iron deficiency is not associated with an increased risk of hospitalization or death from infection, and may reduce such events, especially when TSAT is <20%. ClinicalTrials.gov, NCT02642562.

Iron Deficiency Anaemia in Pregnancy: A Narrative Review from a Clinical Perspective.

Anaemia in pregnancy is a global problem of significance in all settings. The most common cause is iron deficiency. Large numbers of women are affected, ranging up to 25-30% antenatally and 20-40% postnatally. It is associated with serious adverse outcomes for both the mother and her baby. The risk of low birth weight, preterm birth, postpartum haemorrhage, stillbirth, and neonatal death are all increased in the presence of anaemia. For the infants of affected pregnancies, complications may include neurocognitive impairment. Making an accurate diagnosis during pregnancy has its challenges, which include the choice of thresholds of haemoglobin below which a diagnosis of anaemia in each trimester of pregnancy can be made and, aligned with this question, which are the most appropriate biomarkers to use to define iron deficiency. Treatment with oral iron supplements increases the haemoglobin concentration and corrects iron deficiency. But high numbers of women fail to respond, probably due to poor adherence to medication, resulting from side effects. This has resulted in an increased use of more expensive intravenous iron. Doubts remain about the optimal regimen to of oral iron for use (daily, alternate days, or some other frequency) and the cost-effectiveness of intravenous iron. There is interest in strategies for prevention but these have yet to be proven clinically safe and effective.

Ferric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial.

Evidence is lacking that correcting iron deficiency (ID) has clinically important benefits for patients with heart failure with preserved ejection fraction (HFpEF). FAIR-HFpEF was a multicentre, randomized, double-blind trial designed to compare intravenous ferric carboxymaltose (FCM) with placebo (saline) in 200 patients with symptomatic HFpEF and ID (serum ferritin < 100 ng/mL or ferritin 100-299 ng/mL with transferrin saturation < 20%). The primary endpoint was change in 6-min walking test distance (6MWTD) from baseline to week 24. Secondary endpoints included changes in New York Heart Association class, patient global assessment, and health-related quality of life (QoL). The trial was stopped because of slow recruitment after 39 patients had been included (median age 80 years, 62% women). The change in 6MWTD from baseline to week 24 was greater for those assigned to FCM compared to placebo [least square mean difference 49 m, 95% confidence interval (CI) 5-93; P = .029]. Changes in secondary endpoints were not significantly different between groups. The total number of adverse events (76 vs. 114) and serious adverse events (5 vs. 19; rate ratio 0.27, 95% CI 0.07-0.96; P = .043) was lower with FCM than placebo. In patients with HFpEF and markers of ID, intravenous FCM improved 6MWTD and was associated with fewer serious adverse events. However, the trial lacked sufficient power to identify or refute effects on symptoms or QoL. The potential benefits of intravenous iron in HFpEF with ID should be investigated further in a larger cohort.

An Electrolytic Elemental Iron Powder Effectively Regenerates Hemoglobin in Anemic Rats and Is Relatively Well Absorbed When Compared to Ferrous Sulfate Monohydrate.

Elemental iron powders are used as food fortificants to reduce the incidence of iron deficiency anemia. However, many commercially available iron powders are relatively untested in vivo. The purpose of this study was to determine the hemoglobin regeneration efficiency (HRE) and relative iron bioavailability (RBV) of an electrolytic elemental iron powder (EIP), by treating anemic rats with 14 d iron repletion diets fortified with four different concentrations (12, 24, 36, or 48 mg iron/kg diet) of EIP and bakery-grade ferrous sulfate monohydrate (FS; FeSO4•H2O), or no added iron (control); n = 9-12/group. The HRE of FS was significantly higher (p ≤ 0.05) than EIP at each concentration of dietary iron tested. For EIP, the HREs (ratios) of diets containing 12, 24, 36, and 48 mg iron/kg were 0.356, 0.205, 0.197, and 0.163, respectively. For both EIP and FS, HRE was inversely associated with increasing dietary iron. The RBVs (%) of iron from EIP in diets at 12, 24, 36, and 48 mg iron/kg as compared to FS were 64.5, 59.1, 50.6, and 54.3%, respectively. Overall, findings show that at the concentrations of iron tested, EIP has RBVs greater than 50% and is an effective fortification agent to replenish hemoglobin and correct iron deficiency anemia.

Hemoglobin Regeneration Efficiency and Relative Iron Bioavailability of Four Elemental Iron Powders in Rats.

Effective food fortification strategies using elemental iron powders (EIPs) are needed to combat iron deficiency anemia. The purpose of this study was to determine hemoglobin regeneration efficiency (HRE) and relative iron bioavailability (RBV) of four food-grade EIPs (El-Lyte (EL), Hi-Sol (HS), H-325 (H3), and A-131 (A1)) by treating anemic rats with 14 d iron repletion diets (uncooked and cooked), fortified with a 12, 24, or 36 mg iron/kg diet of the EIPs, ferrous sulfate monohydrate (FS, FeSO4•H2O), or no added iron (control), n = 9-12/group. The ability of EL and HS to maintain hemoglobin for 6 weeks on the 6 mg iron/kg diet was also studied. The dissolution rate of iron from the EIPs was measured in hydrochloric acid at pH 1.0. Compared to FS, the EL, HS, and A1 EIPs had >50% overall RBV, with the following order: HS > A1 > EL > H3 (p ≤ 0.05); the effect of cooking was not significant (p > 0.05). Dissolution testing revealed that the mean RBV of the EIPs was positively associated with the percentage of iron solubility. In the 6-week maintenance study, EL and HS maintained hemoglobin as well as FS. Overall, the findings show that at the concentrations of iron tested, these EIPs are effective fortification agents to replenish hemoglobin and correct iron deficiency anemia.

Clinical benefits of parenteral iron carboxymaltose in patients with colorectal cancer: a retrospective observational study

Background. The high incidence of anemia in colorectal cancer and its severe consequences for patients determine the need for timely diagnosis and correction of this condition. At the same time, it is extremely important to choose a method for correcting anemia, allowing to achieve maximum efficiency and safety. Aim. To evaluate perioperative methods for correcting iron deficiency anemia in patients with colorectal cancer based on a comparative analysis of the clinical results of intravenous administration of iron carboxymaltose and transfusion of blood components. Materials and methods. The results of treatment of 594 patients with colorectal cancer operated on in 2022 at the department of surgical treatment methods No. 3 (abdominal oncology No. 1) of the Volgograd Regional Clinical Oncology Dispensary were studied. Stratification of patients into groups was carried out using the method of pseudo-randomization by sex and age to eliminate confounding errors. After pseudo-randomization in a 1:1 ratio, the sample of patients with anemia was divided into 2 groups (main group – 124 patients, in whose treatment blood-saving techniques and parenteral administration of iron carboxymaltose were used, and control group – 124 patients, for treatment of anemia in which transfusions of blood components were used). In 98 (39.5%) cases hemicolectomies were performed, in 88 (35.5%) – anterior resections of the rectum, in 36 (14.5%) – resections of the sigmoid colon, in 18 (7.3%) – extirpations of the rectum, in 8 (3.2%) – resection of the transverse colon, 217 (87.5%) operations were performed through laparotomy access, 31 (12.5%) using minimally invasive technologies. Results. The frequency of postoperative complications of grade III–V according to Clavien–Dindo score in the main group (4.8%, 6/124) was statistically significantly lower compared to the control group (14.5%, 18/124) [χ2=6.643; p=0.01]. Postoperative mortality in the main group was 0.8% (1/124), in the control group – 5.6% (7/124) [χ2=4.65; p=0.032]. Conclusion. The use of blood-saving technologies with parenteral administration of iron carboxymaltose in patients with colorectal cancer leads to a reduction in the number of postoperative complications and the level of postoperative mortality.

Assessing the Efficacy of Bovine Lactoferrin to Correct Iron Deficiency Anaemia in Women of Reproductive Age: A Double Blind Randomized Controlled Trial in Mirpur, Dhaka

Assessing the Efficacy of Bovine Lactoferrin to Correct Iron Deficiency Anaemia in Women of Reproductive Age: A Double Blind Randomized Controlled Trial in Mirpur, Dhaka

#686 The impact of Ferric Derisomaltose (FDI) on role physical functioning in iron deficient but not anaemic patients with chronic kidney disease

Abstract Background and Aims Chronic kidney disease (CKD) is a progressive disorder affecting physiological function, specifically iron deficiency. Iron is crucial for red blood cell production, oxygen transport, mitochondrial function, and cardiac function. Iron deficiency in patients with CKD results from decreased absorption and mobilization, which leads to anaemia, reduced functional capacity, increased cardiac risk, and poorer quality of life. The Iron and the Heart Trial investigated whether correcting iron deficiency in CKD patients (using a single dose of 1000 mg of intravenous (IV) ferric derisomaltose (FDI)) improved functional capacity, as measured by the six-minute walk test, and health-related quality of life (HRQoL) outcomes, including Physical and Mental Health. The SF-36v2 Health Survey tool was used to quantify HRQoL outcomes. Patients identify that whilst clinical outcomes such as survival and functional capacity are important; HRQoL and the symptoms associated with disease burden are far more debilitating. Currently research on how Role Physical functioning, which assesses limitations in routine activities, affects QoL in people with CKD and iron deficiency is limited. This study aimed to explore if correcting iron deficiency in people with CKD without anaemia using IV FDI, improved Role Physical outcomes compared to a placebo group post-infusion at 3 months from the Iron and Heart Trial. Method The Iron and the Heart Trial was a multicentre double blinded randomised study in which non-anaemic CKD patients with iron deficiency were given 1000 mg of IV iron (FDI), compared to a placebo infusion at baseline, and assessed at 1 month and 3-months post-infusion, to evaluate the impact on exercise capacity. Secondary objectives of the trial included impact of iron therapy on QoL. This analysis focused on “Role Physical” as a QoL parameter in the trial participants. A total of 54 CKD patients with iron deficiency but no anaemia (Group 1) were enrolled in the trial and randomly assigned in a 1:1 ratio to either the FDI or placebo group. Within the 54 patients, 26 patients received FDI, and 28 patients received placebo. 10 CKD patients without anaemia or iron deficiency (Group 2) were also included, they did not receive any treatment and were followed up at the same time points as Group 1. Each group completed the Role Physical parameter of the SF-36v2 survey which assessed if participants had cut down the amount of time spent on activities, accomplished less, were limited, or performed tasks with more difficulty because of their condition. The collected responses were categorical variables that were summarised using number (%) and then normalised and summarised using mean (standard deviations). All analyses were undertaken using Microsoft Excel. Results At baseline the Role Physical means (SD) were as follows: placebo 42.8 ± 11.9, FDI 42.1 ± 11.0, Group 2 45.9 ± 9.4. Prior to any intervention, mean Role Physical outcomes were numerically poorer in those with CKD and iron deficiency (placebo and FDI) compared to those with CKD and no iron deficiency (Group 2) (Fig. 1a). Following intervention at 3 months the mean (SD) scores for each group were—placebo 37.5 ± 14.6, FDI 40.9 ± 11.4, Group 2 44.0 ± 13.2. The placebo group experienced a decrease of 12.3% in the mean score for Role Physical outcomes in comparison to their baseline whilst, FDI group only experienced a 3% decrease. For Group 2, there was a decrease of 4% from baseline to 3 months (Fig. 1b). Conclusion Our study showed that while FDI may not improve QoL outcomes, Role Physical functioning, in individuals with CKD and iron deficiency, it may still play a role in slowing the deterioration of these outcomes. Caution must be exercised when interpreting our findings due to the limitations of our study, and further research with sufficient power is needed to extend the findings of the study with a larger sample size to be able to make treatment recommendations for individuals with CKD and iron deficiency.

Iron deficiency therapy in pregnant women: advantages and new possibilities of iron carboxymaltose

Introduction. Impact of iron deficiency on pregnancy outcomes appears an urgent issue despite generally accepted standards of therapy. Iron needs increase during pregnancy and manifestations of its deficiency reduce QoL in pregnant women and worsen newborn health. Ferric carboxymaltose helps overcome iron deficiency in a quick and efficient manner from the 2nd trimester.Aim. To analyse the results of ferric carboxymaltose therapy of iron deficiency conditions in pregnant women.Materials and methods. In this article we presented our own experience in providing ferric carboxymaltose therapy to treat iron deficiency in 152 pregnant women from the 2nd trimester.Results and discussion. Correction of anaemic syndrome was observed in more than 73.3% (up to 93.3% depending on the severity of primary anaemia) as early as the first week after administration of ferric carboxymaltose. Haemoglobin and ferritin levels at 3 week post-infusion were significantly higher than pre-infusion levels (p &lt; 0.001). Improvement of haemoglobin levels at 6 weeks after initiation of therapy was achieved in all women with mild anaemia and in 98.5% of women with severe anaemia. No definite severe hypersensitivity reactions were detected. The overall incidence of side effects was 10.5%, with headache being the most frequently reported type (7.9%). All pregnancies resulted in a live birth without malformations; the rate of preterm birth was 9.5%.Conclusion. Ferric carboxymaltose is an effective drug to quickly correct iron deficiency in pregnant women with a minimum number of adverse reactions and without negative impact on newborn health.

Efficacy and Safety of Oral Supplementation with Liposomal Iron in Non-Dialysis Chronic Kidney Disease Patients with Iron Deficiency.

Iron deficiency is common in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). Oral iron supplementation is recommended in these patients, but it is associated with a higher incidence of gastrointestinal adverse reactions. Liposomal iron therapy has been proposed as a new iron formulation, improving iron bioavailability with less side effects; however, few data are available in patients with NDD-CKD. We designed a single-arm pilot study to evaluate the efficacy of liposomal iron administered for six months in correcting iron deficiency (defined as serum ferritin < 100 ng/mL and/or transferrin saturation < 20%) in patients with NDD-CKD stages 1-5. The primary endpoints were the achievement of serum ferritin ≥ 100 ng/mL and transferrin saturation ≥ 20%. Secondary outcomes were hemoglobin (Hb) changes and the safety of liposomal iron. The efficacy population included 34/38 patients, who completed at least one visit after baseline. Liposomal iron increased the achievement of transferrin saturation targets from 11.8% at baseline to 50.0% at month 6 (p = 0.002), while no significant correction of serum ferritin (p = 0.214) and Hb was found (p = 0.465). When patients were stratified by anemia (Hb < 12 g/dL in women and Hb < 13 g/dL in men), a significant improvement of transferrin saturation was observed only in anemic patients (from 13.3 ± 5.8% to 20.2 ± 8.1%, p = 0.012). Hb values slightly increased at month 6 only in anemic patients (+0.60 g/dL, 95%CI -0.27 to +1.48), but not in those without anemia (+0.08 g/dL, 95%CI -0.73 to +0.88). In patients taking at least one dose of liposomal iron (safety population, n = 38), the study drug was discontinued in eight patients due to death (n = 2), a switch to intravenous iron (n = 2), and the occurrence of side effects (n = 4). The use of liposomal iron in patients with NDD-CKD is associated with a partial correction of transferrin saturation, with no significant effect on iron storage and Hb levels.

Oral iron supplementation: new formulations, old questions.

Iron-deficiency anemia and pre-anemic iron deficiency are the most frequent pathologies. The first line of treatment involves oral iron supplementation. The simplest, least expensive, and most commonly prescribed drug is ferrous sulfate, while other ferrous salts and ferric complexes with polysaccharides or succinylated milk proteins are also widely used. In recent years, novel iron formulations have been developed, such as the lipophilic iron donor ferric maltol, or nanoparticle encapsulated sucrosomial® iron. Oral iron supplementation is usually efficacious in correcting iron-deficiency anemia and replenishing iron stores but causes gastrointestinal side effects that reduce compliance. When oral iron supplementation is contraindicated, intravenous iron therapy can rapidly achieve therapeutic targets without gastrointestinal complications. Herein, we critically review literature on relative efficacy and tolerability of currently available oral iron supplements, and summarize recent data on optimal dosage and frequency.

Rationale and design of a prospective randomized study of the effect of ferric carboxymaltose therapy on quality of life and clinical picture of heart failure with preserved ejection fraction in patients with iron deficiency

Introduction. The prevalence of iron deficiency (ID) among patients with chronic heart failure (CHF) ranges from 50% to 80%. It has been established that ID is a significant predictor of adverse outcomes and mortality in CHF, and is also associated with a decrease in exercise tolerance. The use of oral iron preparations for the purpose of its correction is limited by the high frequency of adverse events and, in some cases, their ineffectiveness in CHF. Ferric carboxymaltose has a high potential in the correction of ID, which has proven itself well in the cohort of patients with CHF, but its effectiveness has not been precisely established in CHF.Aim: To evaluate the effect of ferric carboxymaltose therapy on the quality of life, functional status, and clinical picture of CHF in patients with diagnosed iron deficiency.Material and Methods. It is a prospective randomized cohort study. It is planned to include 70 adult patients with CHF (NYHA II-III) and diagnosed ID: group 1 (n = 35) – group of drug therapy with ferric carboxymaltose, group 2 (n = 35) – without drug therapy. A control group of patients without ID (n = 30) will also be recruited. The prospective part involves the observation of patients with repeated visits after 6, 12 months, during which the indicators of quality of life, functional status, clinical picture of CHF, structural and functional echocardiographic indicators of LV and right heart, as well as the presence of repeated hospitalizations for CHF and death from all causes will be evaluated.

Randomized Controlled Trial of Intravenous Ferric Carboxymaltose vs Oral Iron to Treat Iron Deficiency Anemia After Variceal Bleed in Patients With Cirrhosis.

Limited evidence exists on the optimal strategy to correct iron deficiency anemia after variceal bleeding (VB) in cirrhosis. This trial compared the efficacy and safety of intravenous ferric carboxymaltose (IV-FCM) with those of oral iron therapy in this cohort. In this open-label, single-center, randomized controlled trial, eligible patients with hemoglobin <10 g/dL and iron deficiency (ferritin <100 ng/mL) after VB received either IV-FCM (1,500-2,000 mg) divided into 2 doses (n = 48) or oral carbonyl iron (100 mg elemental iron/day) (n = 44) for 3 months. The primary outcome was change in hemoglobin at 3 months. Secondary outcomes included improvement in anemia (last hemoglobin >12 g/dL), normalization of iron stores (ferritin >100 ng/mL), liver-related adverse events, adverse drug reactions, and changes in quality of life (CLDQOL questionnaire). Baseline characteristics, including median Child-Turcotte-Pugh score 7 (interquartile range [IQR] 6-9), Model for End-Stage Liver Disease score 12 (IQR 10-17), blood hemoglobin (8.25 ± 1.06 g/dL), and ferritin (30.00 ng/mL [15.00-66.50]), were comparable in both arms. The median increase in hemoglobin at 3 months in the IV and oral arms was 3.65 g/dL (IQR 2.55-5.25) and 1.10 g/dL (IQR 0.05-2.90 g/dL) ( P < 0.001), respectively. Iron stores normalized in 84.6% and 21% of the IV and oral arms, respectively ( P < 0.001). Anemia improved in 50% and 21.9% in the IV and oral arms, respectively ( P < 0.009). Patients in the IV arm showed a significant improvement in all domains of CLDQOL. Liver-related adverse events were comparable in both arms. Transient mild/moderate hypophosphatemia developed in 43% of patients receiving IV-FCM. Intravenous iron replacement is efficacious and safe to treat iron deficiency anemia after VB in patients with cirrhosis.

Iron deficiency, anemia, and patient-reported outcomes in kidney transplant recipients

Kidney transplant recipients (KTRs) experience more fatigue, anxiety, and depressive symptoms and lower concentration and health-related quality of life (HRQoL) compared with the general population. Anemia is a potential cause that is well-recognized and treated. Iron deficiency, however, is often unrecognized, despite its potential detrimental effects related to and unrelated to anemia. We investigated the interplay of anemia, iron deficiency, and patient-reported outcomes in 814 outpatient KTRs (62% male, age 56 ± 13 years) enrolled in the TransplantLines Biobank and Cohort Study (Groningen, The Netherlands). In total, 28% had iron deficiency (ie, transferrin saturation < 20% and ferritin < 100 μg/L), and 29% had anemia (World Health Organization criteria). In linear regression analyses, iron deficiency, but not anemia, was associated with more fatigue, worse concentration, lower wellbeing, more anxiety, more depressive symptoms, and lower HRQoL, independent of age, sex, estimated glomerular filtration rate, anemia, and other potential confounders. In the fully adjusted logistic regression models, iron deficiency was associated with an estimated 53% higher risk of severe fatigue, a 100% higher risk of major depressive symptoms, and a 51% higher chance of being at risk for sick leave/work disability. Clinical trials are needed to investigate the effect of iron deficiency correction on patient-reported outcomes and HRQoL in KTRs.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: Preoperative Phase – Preoperative management of the patient's anemia

Managing anemia before surgery is extremely important as it is a clinical condition that can significantly increase surgical risk and affect patient outcomes. Anemia is characterized by a reduction in the number of red blood cells or hemoglobin levels leading to a lower oxygen-carrying capacity of the blood. Proper treatment requires a multifaceted approach to ensure patients are in the best possible condition for surgery and to minimize potential complications. The challenge is recognizing anemia early and implementing a timely intervention to correct it. Anemic patients are more susceptible to surgical complications such as increased infection rates, slower wound healing and increased risk of cardiovascular events during and after surgery. Additionally, anemia can exacerbate existing medical conditions, causing greater strain on organs and organ systems. To correct anemia and optimize patient outcomes, several essential measures must be taken with the most common being identifying and correcting iron deficiency.

Cost-utility analysis of ferric derisomaltose versus ferric carboxymaltose in patients with inflammatory bowel disease and iron deficiency anemia in England

Aims Anemia is the most common extraintestinal complication of inflammatory bowel disease (IBD), with approximately half of cases caused by iron deficiency (ID). Intravenous iron is the preferred ID anemia (IDA) treatment where oral iron is contraindicated, ineffective or not tolerated, or where ID correction is urgent. The objective was to evaluate the cost-utility of ferric derisomaltose (FDI) versus ferric carboxymaltose (FCM) in patients with IBD and IDA in England, in whom IV iron treatment is preferred. Materials and methods A patient-level simulation model was developed, capturing quality of life (QoL) differences based on SF-36v2 data from the PHOSPHARE-IBD randomized controlled trial, monitoring and incidence of post-infusion hypophosphatemia, and number of iron infusions required. Analyses were conducted over a five-year time horizon from the Department of Health and Social Care (DHSC) perspective, with healthcare provider and societal perspectives adopted in separate analyses. Future costs and effects were discounted at 3.5% per annum and one-way and probabilistic sensitivity analyses were performed. Results FDI increased quality-adjusted life expectancy by 0.075 QALYs versus FCM from 2.57 QALYs to 2.65 QALYs per patient. Patients receiving FDI required 1.63 fewer iron infusions over the five-year time horizon, driving infusion-related cost savings of GBP 496 per patient (GBP 2,188 versus GBP 1,692) from the DHSC perspective. Costs of monitoring and treating hypophosphatemia after FCM were GBP 226, yielding total savings of GBP 722 per patient (GBP 2,414 versus GBP 1,692) over the five-year time horizon. FDI also led to reduced costs versus FCM in the societal and provider analyses and was therefore the dominant intervention across all three perspectives. Limitations The analysis did not capture patient adherence, hypophosphatemic osteomalacia, or fractures. Conclusions Results showed that FDI improved patient QoL and reduced direct healthcare expenditure versus FCM in patients with IBD and IDA in England.

Effect of iron supplementation on physical and physiological variables of active females

Introduction: This study investigates the impact of iron supplementation on physiological and physical variables among active female students. Iron is essential for oxygen transport and is routinely depleted among iron runners due to exercise intensity. Considering the complicated relationship between exercise intensity, participants’ current health status, eating habits, and normal iron levels, this study seeks to illuminate whether iron supplementation benefits female athletes recruited among students from Burdwan University’s M.P.Ed. Department. Materials and Methods: This study targets a population of 10 female students aged between 22 and 27 years. Participants were selected on the basis of the homogeneity of their age, height, and weight. The study design was conducted as pretest/posttest research. Participants were provided with iron supplements, Punarnaba Moondur, with 250 mg of iron to be taken twice a day with honey and fed as specified. Hemoglobin level and various physiological and physical test parameters were chosen as primary outcomes. Using a t-test setting, P = 0.05, the difference between pre- and postparameters was analyzed. Results: Analysis indicates significant positive variations in postintervention hemoglobin level results in relation to preintervention results. Thus, the iron level was successfully increased. Comparably, various physiological functions and physical fitness parameters were improved among the participants: Their muscles worked more efficiently, and physical capabilities were generally enhanced. Conclusion: The use of Punarnaba Moondur as an iron supplement significantly increased the amount of hemoglobin among the active students. This development led to improved physiological and physical capacity. Parametric supplementation can be used to correct exercise-induced iron deficiency in female athletes to increase exercise performance and health outcomes. This study highlights the value of attenuation nutrition as an intervention tool against exercise-induced iron depletion.

Новые подходы в лечении и профилактике анемии беременных

Iron deficiency anemia is the most common extragenital pathology in pregnancy. Its relevance is determined by its impact on obstetric and perinatal outcomes, since iron deficiency negatively affects the course of pregnancy and fetal development. Timely detection, treatment, and prevention of iron deficiency conditions during pregnancy are necessary to reduce the risk of complications. The article discusses the main issues and criteria of rational diagnosis and modern approaches to the anemia treatment. It notes the importance of timely and full correction of iron deficiency to avoid the development of fetal neurocognitive disorders. Special attention is paid to the choice of iron products, the benefits and drawbacks of various forms of iron that limit their use in pregnant women. Separately, an innovative dosage form sucrosomal® iron is viewed, which can be considered as an effective means of treating this pathology. The article also presents the clinical studies and pharmacokinetic characteristics of oral sucrosomal iron, using which the necessary effect is achieved with lower doses in the absence of adverse events, which is of paramount importance during gestation. KEYWORDS: anemia of pregnancy, iron deficiency anemia, iron deficiency, iron preparations, sucrosomal iron, sucrosome. FOR CITATION: Dobrokhotova Yu.E., Romanovskaya V.V., Narimanova M.R. New methods for the treatment and prevention of anemia during pregnancy. Russian Journal of Woman and Child Health. 2024;7(1):26–34 (in Russ.). DOI: 10.32364/2618-8430-2024-7-1-4.

Early improvement of global longitudinal strain after iron deficiency correction in heart failure with reduced ejection fraction.

Iron deficiency correction with ferric carboxymaltose improves symptoms and reduces rehospitalization in patients with reduced left ventricular ejection fraction. The mechanisms underlying these improvements are poorly understood. This study aimed to determine changes in left ventricular contractility after iron treatment as reflected in global longitudinal strain. Prospective single-center study including 43 adults with reduced ejection fraction, non-anemic iron deficiency, and functional class II-III heart failure despite optimal medical treatment. Global longitudinal strain through speckle-tracking echocardiography was measured at baseline and 4weeks after ferric carboxymaltose. A significant improvement in global longitudinal strain was detected (from -12.3%±4.0% at baseline to -15.6%±4.1%, p<.001); ferritin and transferrin saturation index had increased, but ejection fraction presented no significant changes (baseline 35.7%±4.6%, follow-up 37.2%±6.6%, p=.073). In patients with heart failure and reduced ejection fraction, the correction of iron deficiency with ferric carboxymaltose is associated with an early improvement in global longitudinal strain, possibly suggesting a direct effect of iron correction on myocardial contractility.