Iron Sucrose Group Research Articles

Randomized comparative study between ferric carboxymaltose and iron sucrose for correction of anemia in antenatal women

Anemia during pregnancy is a significant global health concern. This study aims to evaluate the efficacy and safety of Ferric Carboxymaltose (FCM) compared to Iron Sucrose (ISC) in treating mild to moderate iron deficiency anemia (IDA) in pregnant women. A randomized prospective control study was conducted with antenatal women suffering from mild to moderate anemia at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital from December 2018 to November 2019. Participants were randomly assigned to either Group A (FCM) or Group B (ISC). A total of 128 women were randomized, with 64 in each group. The mean increase in hemoglobin was significantly higher in the FCM group (1.34 g/dl) compared to the ISC group (0.98 g/dl) (p < 0.001). FCM required fewer administrations, improving patient compliance. Both treatments were well-tolerated, with minor local reactions observed. FCM offers a more effective, convenient, and well-tolerated treatment option for IDA in pregnancy compared to ISC.

A comparative study of ferric carboxymaltose and iron sucrose as a parenteral iron treatment in iron deficiency anemia during pregnancy in a tertiary care hospital

Background: Anemia from the Greek word (anhaima) meaning “without blood” is the deficiency of red blood cell and/or hemoglobin which result in reduced oxygen-carrying capacity of blood causing tissue hypoxia. Aims and Objectives: To study the efficacy and safety of intravenous ferric carboxymaltose (FCM) versus iron sucrose in the management of iron deficiency anemia in pregnancy. Materials and Methods: A prospective, single-center, comparative interventional randomized study was carried among 180 antenatal mother admitted to antenatal ward in the Department of Obstetrics and Gynaecology of Burdwan Medical College and Hospital, from July 1st, 2020, to December 30th, 2021. Results: A total of 180 patients, 90 patients in each FCM and iron sucrose group, were included in the study. There was significant (P=0.001) mean change in hemoglobin (Hb) level in both the groups from pre-treatment to 3 and 6-week post-treatment. There was also a significant (P=0.001) mean change in ferritin level in both the groups from pre-treatment to 3 and 6-week post-treatment. The mean change in Hb level and ferritin level was higher among patients of FCM compared to iron sucrose. The adverse reactions were lower among patients of FCM than iron sucrose. Conclusions: This study found that FCM is safer than iron sucrose. Treatment with FCM resulted in rapid replenishment of iron stores in pregnant women with significantly high rise of Hb and ferritin levels over a 6-week period with lesser adverse effects.

Evaluation of the efficacy and safety of intravenous infusion of ferric derisomaltose in the treatment of iron deficiency anemia: a single-center retrospective analysis

Objective: To investigate the clinical efficacy and safety of ferric derisomaltose injection versus iron sucrose injection in the treatment of iron deficiency anemia (IDA) . Methods: A total of 120 patients with iron deficiency anemia admitted from June 2021 to March 2023 were given intravenous iron supplementation with ferric derisomaltose to assess the efficacy and safety of hemoglobin (HGB) elevation before and after treatment. Simultaneously, the clinical effects of iron supplementation with iron sucrose were compared to those of inpatient patients during the same period. Results: Baseline values were comparable in both groups. Within 12 weeks of treatment, the elevated HGB level in the ferric derisomaltose group was higher than that of the iron sucrose group, with a statistical difference at all time points, and the proportion of HGB increased over 20 g/L in the patients treated for 4 weeks was higher (98.7%, 75.9% ). During the treatment with ferric derisomaltose and iron sucrose, the proportion of mild adverse reactions in the ferric derisomaltose group was slightly lower than that of the iron sucrose group, and neither group experienced any serious adverse reactions. The patients responded well to the infusion treatment, with no reports of pain or pigmentation at the injection site. Conclusion: The treatment of IDA patients with ferric derisomaltose has a satisfactory curative effect, with the advantages of rapidity, accuracy, and safety. Therefore, it is worthy of widespread clinical use.

Abstract 13670: Prevalence and Long-Term Outcomes of Intravenous Iron Sucrose Therapy in Heart Failure With Reduced Ejection Fraction: A Single Institution Retrospective Cohort Study

Background: Iron deficiency (ID) is prevalent in heart failure with reduced ejection fraction (HFrEF) defined as left ventricular ejection fraction (LVEF) ≤ 40%. Most trials used in the 2022 AHA/ACC guidelines studied iron carboxymaltose; most had a short follow-up and evaluated heart failure readmissions. We explored the prevalence of iron use, long-term therapeutic benefits, and impact on all-cause readmission for patients with HFrEF. Methods: In this retrospective cohort study, we analyzed electronic medical record data from a university hospital from 2016 to 2021 with an ICD-10 code of systolic heart failure (LVEF < 50%) and ID, or iron deficiency anemia (IDA) (n=619). Intravenous (IV) iron sucrose group was matched to a control group (n = 43) by propensity score matching for age and sex. Conditional logistic regression was utilized to estimate unadjusted odds ratios (uOR) with 95% confidence interval (CI), while Mann-Whitney test was utilized to compare median values of nonparametric estimates. Statistical analysis was done in SAS version 9.4. Results: 66.7% of the studied population were male and 61.1% were ≥ 65 years. The common comorbid conditions were ischemic cardiomyopathy (39.6%), chronic kidney disease (CKD) (26.2%), and gastrointestinal (GI) bleeding (12.3%). ID was present in 115 (18.6%); IDA in 95 (15.4%) and 43 (6.9%) received IV iron sucrose. IV iron administration was significantly associated with LVEF 41-49% (uOR = 2.65, 95% CI: 1.10 - 6.43), GI bleeding (uOR = 16.00, 95% CI: 2.12 - 120.65), chronic kidney disease (uOR = 3.67, 95% CI: 1.49 - 9.04), iron deficiency (uOR = 26.00, 95% CI: 3.53 - 191.60]) and iron deficiency anemia (uOR = 24.00, 95% CI: 3.23 - 177.41). LVEF ≤40% was non-significantly associated with all-cause mortality (uOR = 1.50, 95% CI: 0.61 - 3.67). The IV iron group had a higher median rate of 6-year readmissions (8 [IQR:8] vs.1 [2]; p<0.001), and blood transfusions (11 [24] vs. 3.5 [2]; p=0.05). Conclusions: Patients with HFrEF were less likely to receive IV iron sucrose and more likely to die. Those with frequent blood transfusions, GI hemorrhage, and CKD were more likely to receive IV iron. The study indicates the impact of disease severity and comorbidities on management. Larger studies are needed to investigate this postulation.

TO COMPARE INTRAVENOUS FERRIC CARBOXYMALTOSE VERSUS INTRAVENOUS IRON SUCROSE IN POST-PARTUM WOMEN WITH IRON-DEFICIENCY ANEMIA

Objectives: The objective of this study was to compare intravenous ferric carboxymaltose (FCM) versus intravenous iron sucrose in post-partum women with iron-deficiency anemia (IDA). Methods: This was a hospital-based prospective randomized controlled study, comprising 100 post-natal women with IDA with hemoglobin level <11 g/dL admitted in post-natal ward of the Obstetrics and Gynecology Department in SP Medical College, Bikaner, from June 2021 to May 2022. Results: In age, residence, socioeconomic status, the incidence of IDA in both the groups were comparable and is more among rural areas, low socioeconomic status. Improvement in hemoglobin, serum ferritin, and blood indices in both the iron sucrose and FCM groups, but it was faster and greater with ferric carboxymaltose when compared with iron sucrose. Other advantages are large dose administration at 1 time, therefore, lesser total number of doses required in the FCM group as compared to the IS group. Conclusion: FCM is well tolerated, safer, and effective than iron sucrose in treatment of post-natal IDA.

A Comparative Study to Assess the Safety and Efficacy between Intravenous Iron Sucrose and Ferric Carboxymaltose in the Treatment of Iron Deficiency Anemia in Pregnancy – A Single Center Prospective Observational Study from a Tertiary Care Center.

Abstract Objective: To Compare the safety and efficacy between intravenous iron sucrose and ferric carboxy maltose in the treatment of iron deficiency anemia in pregnancy. Methodology: A Prospective study was conducted on 100 antenatal women with iron deficiency anemia in department of Obstetrics and Gynecology of a tertiary care center in northern India from June 2021 to May 2022. Results: The mean age in group A (Iron Sucrose group) was 25+ 2.83 years and in group B (FCM group) was 24.08+4.45 years. In group A (IS group) the average increase in Hb level was about 1.24 ± 0.29 gm/dl at 3 weeks and 2.62 ± 0.2 gm/dl at 6 weeks. In group B (FCM group) the average increase was about 1.74 ± 0.42 gm/dl at 3 weeks and 4.15 ± 1.94 gm/dl at 6 weeks. In IS group the average increase in ferritin was about 18.83 ± 18.18 ng/dl at 3 weeks and 43.54 ± 31.71 ng/dl at 6 weeks. In FCM group the average increase was about 34 ± 19.83 ng/dl at 3 weeks and 96.62 ± 50.7 ng/dl at 6 weeks. P value at both time periods was 0.0001, which is highly significant. 43 patients (86%) in Group B as compared to 19 patients (38%) in group A showed improvement in anaemia in PBS findings over 3 week and 6 week period, which was statistically significant with a P value of 0.024. In Group A (IS group ) only two patients complained of diarrhoea, two complained of headache, 1 patient complained of nausea ,vomiting, one complained of nausea only, In Group B (FCM group) total 3 patients (6%) complained of minor reactions like nausea, vomiting and itching. There were mild side effects only in both the groups. Conclusion: Intravenous FCM is more efficient and better alternative than iron sucrose in the treatment of iron deficiency anaemia in pregnancy. Key Words: IDA, FCM, IS, Ferritin, Haemoglobin.

To evaluate the efficacy and safety of intravenous ferrous carboxymaltose compared with Iron sucrose in treating iron deficiency anemia in postpartum period

Background: Iron deficiency anemia continues to be a serious problem in developing countries resulting in spectrum of adverse events in pregnant women. The first choice for prophylaxis and treatment of mild IDA in pregnancy is oral iron therapy. However, in patients with moderate and severe anemia, oral therapy takes very long time and compliance could be a big issue in our country. Thus, pregnant women with moderate anemia should be better treated with parenteral iron therapy. Postpartum women were eligible for the study with hemoglobin level <10 g/dl, while those with sickle cell anemia, aplastic anemia, megaloblastic anemia, etc., or having allergy to parental iron were considered not eligible for this study. The eligible women were randomly categorized to receive intravenous iron sucrose and intravenous ferrous carboxymaltose. Aims and Objectives: (1) To Compare ferrous carboxymaltose with iron sucrose in treating iron deficiency anemia in postpartum period (2) To assess the adverse effects and patient compliance. Materials and Methods: A comparative, prospective, and randomized distributed in 50 patients within the Department of Obstetrics and Gynecology, MGM Medical College and Hospital, Navi Mumbai. The subjects were randomized into two group, first group receiving iron sucrose, whereas second group receiving ferrous carboxymaltose. Results: Study, 25 women received iron sucrose and 25 women received ferrous carboxymaltose. There was significant higher increase in hemoglobin levels at 6 weeks in ferric carboxymaltose (FCM) group as compared iron sucrose group hemoglobin levels. There was significant higher increase in ferritin levels at 2 and 6 weeks in FCM group as compared iron sucrose group hemoglobin levels. There was significant higher increase in reticulocyte count at 6 week in FCM group as compared iron sucrose group reticulocyte count. Conclusion: Ferric carboxymaltose is safe and efficient in treatment of iron deficiency anemia in postpartum women as compared to iron sucrose with lesser adverse effect and better patient compliance.

Comparison of the use of intravenous iron sucrose with intravenous ferric Carboxymaltose for treatment of iron deficiency anaemia in pregnant patients

BACKGROUND & OBJECTIVE: Iron deficiency results in major disabilities and death all over the world, about two billion people are suffering from anaemia at the moment. To compare intravenous iron sucrose with intravenous ferric carboxymaltose in terms of mean change in hemoglobin level and mean corpuscular volume (MCV) for treatment of iron deficiency anaemia in pregnant patients.
 METHODOLOGY: Prospective comparative study was conducted at the department of Obstetrics/ Gynecology of POF Hospital Wah Cantt and HIT Hospital Taxila Cantt. The study duration was 2 years, from January 2017-December 2018. A total of 80 patients were included in the study. Patients were randomly divided into two groups; in Group-A; 40 patients were given intravenous iron sucrose, and in Group B, 40 patients were given intravenous ferric carboxymaltose. Patients were observed for hemoglobin level and mean corpuscular volume (MCV). Data analysis was done with SPSS version 24. An Independent t-test was applied, and results with p-value ≤0.05 were found significant.
 RESULTS: Post-treatment hemoglobin means level in the iron sucrose group was 9.90±0.4SD, and in the intravenous ferric carboxymaltose group, post-treatment hemoglobin was 10.71±0.9SD (p≤0.001). In the iron sucrose group, the post-treatment mean corpuscular volume mean level was 81.94±6.0SD and in the intravenous ferric carboxymaltose group mean post-treatment mean corpuscular volume was 88.08±7.1SD (p≤0.001)
 CONCLUSION: Treatment with intravenous iron caboxymaltose is superior to intravenous iron sucrose with respect to hematological response, which seems to be safe, as very few severe side effects were observed.

Differential Pharmacokinetics of Liver Tropism for Iron Sucrose, Ferric Carboxymaltose, and Iron Isomaltoside: A Clue to Their Safety for Dialysis Patients.

Anemia is a major complication of end-stage kidney disease (ESKD). Erythropoiesis-stimulating agents and intravenous (IV) iron are the current backbone of anemia treatment in ESKD. Iron overload induced by IV iron is a potential clinical problem in dialysis patients. We compared the pharmacokinetics of liver accumulation of iron sucrose, currently used worldwide, with two third-generation IV irons (ferric carboxymaltose and iron isomaltoside). We hypothesized that better pharmacokinetics of newer irons could improve the safety of anemia management in ESKD. Liver iron concentration (LIC) was analyzed in 54 dialysis patients by magnetic resonance imaging under different modalities of iron therapy. LIC increased significantly in patients treated with 1.2 g or 2.4 g IV iron sucrose (p < 0.001, Wilcoxon test), whereas no significant increase was observed in patients treated with ferric carboxymaltose or iron isomaltoside (p > 0.05, Wilcoxon-test). Absolute differences in LIC reached 25 μmol/g in the 1.2 g iron sucrose group compared with only 5 μmol/g in the 1 g ferric carboxymaltose and 1 g iron isomaltoside groups (p < 0.0001, Kruskal–Wallis test). These results suggest the beneficial consequences of using ferric carboxymaltose or iron isomaltoside on liver structure in ESKD due to their pharmacokinetic ability to minimize iron overload.

Comparative study of postpartum correction of anaemia by iron sucrose vs blood transfusion

Aim: The aim of the study is to know whether intravenous iron sucrose can be a better alternative in terms of safety and efficacy over blood transfusion in the treatment of anaemia in post-partum. Materials and methods: This are prospective study is conducted in obstetrics and gynaecology Department . All these women are randomly assigned (50 women total , 25 in each group) to receive either 2 doses of intravenous iron sucrose(Group A) or blood transfusion (Group B). Haemoglobin, hemocrit, mean corpuscular volume and serum ferritin estimation is done before treatment and after 1 wk. of correction in both groups to note the improvement in values and monitored for adverse reactions. Results: There is statically significant rise in haemoglobin , hemocrit , mean corpuscular volume , and serum ferritin levels when compared to baseline after 1 week of treatment in both groups. Statistically insignificant rise in mean Hb,Hct was observed when iron sucrose group is compared to blood transfusion group. Conclusion: Intravenous iron sucrose is safe , efficacious and cost-effective treatment for post-partum anaemia. It may be an attractive to blood transfusion which may be associated with minor and major reactions.

Intravenous ferric carboxymaltose versus iron sucrose in iron deficiency anemia of pregnancy

Iron deficiency is the most common nutritional deficiency worldwide. Anemia, defined by the World Health Organization as hemoglobin &amp;#60; 11 g/dl, is frequently seen in the antenatal period and affects 4-48% of women who give birth and severe anemia, with hemoglobin levels &amp;#60;9 g/dl .This study is to evaluate the efficacy and safety of intravenous Ferric Carboxymaltose. (FCM) in comparison with intravenous Iron sucrose complex (ISC) for treatment of iron deficiency anemia in pregnancy.: A comparative, interventional, prospective study was carried out in 100 antenatal patients with Anemia (hemoglobin level between 5 to 9.5 gm/dl) in the department of obstetrics and gynecology, Government Medical College, Baroda, Gujarat, India from September 2017 to August 2018. The subjects were randomized in two groups. First group receiving 1000 mg of intravenous iron sucrose divided in five doses on alternate days (200 mg each) and Second group receiving 1000 mg of intravenous ferric carboxymaltose.: Maximum number of patients in our study were belonged to low socioeconomic group, significantly higher number of women achieved rise of hemoglobin &amp;#62;2gm/dl in FCM group, which was highly significant (p value &amp;#60;0.001). Mean rise of hemoglobin was 1.9 g/dl for FCM group and 1.66gm/dl for iron sucrose group, which was also significant. Serum ferritin level in ferric carboxymaltose group was rises more as compared to iron sucrose group. Unpaired‘t’ test was used to test the significance of rise and compare the rise between two groups.Ferric carboxymaltose is an efficient and better alternative to Iron Sucrose in treating iron deficiency anemia of pregnancy. It has an added advantage of single dose regime with lower side effects.

Comparative study of efficacy of oral iron versus parenteral iron in the treatment of iron deficiency anaemia

Background: Iron deficiency anaemia (IDA) is one of the most widespread nutritional deficiency and common medical conditions seen in everyday clinical practice. IDA has a substantial haematological complication with potentially serious clinical consequences that often may require iron therapy. In most patients, body stores of iron can be restored by oral iron therapy but parenteral iron therapy results rapid correction of haemoglobin levels, faster and higher replenishment of iron stores with better compliance. The study was to compare the efficacy of oral iron (ferrous sulphate) with parenteral iron (iron sucrose) to treat iron deficiency anaemia. Methods: 221 patients were included in the study. 101 patients were given oral iron in the form of ferrous sulphate containing 67 mg of elemental iron three times daily. 120 patients were treated with iron sucrose. After a 25 mg test dose on the first infusion only, this was given at a dose of 300 mg by intravenous infusion diluted in 250 ml of normal saline, every alternate day. Haemoglobin level and serum ferritin of both groups were done before iron therapy, 3 weeks and 12 weeks after iron therapy. Results: The mean±SD rise of haemoglobin concentration 3 weeks after iron therapy in iron sucrose group was 11.2±0.60 g/dL, while in ferrous sulphate group was 9.0±0.58 g/dL. The mean±SD ferritin 3 weeks after iron therapy in iron sucrose group was 81.0±15.18 ng/mL, while in ferrous sulphate group was 27.0±12.22 ng/mL. The mean±SD haemoglobin concentration 12 weeks after iron therapy in iron sucrose group was 12.2±0.60 g/dL, while in ferrous sulphate group was 11.0±0.58 g/dL. The mean±SD ferritin 12 weeks after iron therapy in iron sucrose group was 82.0±16.17 ng/mL, while in ferrous sulphate group was 52.0±12.22 ng/mL. No serious adverse events were reported in either the ferrous sulphate group or iron sucrose group. Conclusion: Iron sucrose causes higher rise in haemoglobin level and serum ferritin as compared to oral iron therapy.

Intravenous iron sucrose vs. blood transfusion in the management of moderate postpartum iron deficiency anemia: A non-randomized quasi-experimental study

IntroductionPostpartum anemia is often over-treated with blood transfusion without clear indication despite having a potential alternative of parenteral iron therapy. The present study aimed to compare the efficacy of intravenous (IV) iron sucrose with blood transfusion in increasing the hematological parameters in postpartum women with moderate anemia. MethodsThis prospective non-randomized quasi-experimental study was conducted among 44 hemodynamically stable postpartum women with moderate anemia (Hb 7–8 g/dl) in the Obstetrics department of Dhaka Medical College Hospital (DMCH) from January to June 2021. Among them, 22 patients received 600 mg of IV iron sucrose after 48 h of delivery for three subsequent days and the other 22 patients received two units of blood transfusion after 48 h of delivery in two subsequent days. The primary endpoint was increase in Hemoglobin (Hb) and serum ferritin level after 6 weeks of the intervention. Two-way repeated measures ANOVA (mixed factor ANOVA) was applied to compare between before and after effect in the two intervention groups. ResultsBaseline Hb and ferritin were 7.4 g/dl and 73.5 μg/l in IV iron group and 7.3 g/dl and 73.2 μg/l in blood transfusion group. Mean Hb level was increased 4.2 g/dl in IV iron sucrose group and 4.5 g/dl in blood transfusion group at sixth week. Besides, serum ferritin level was increased 40.5 μg/l and 44.8 μg/l after six weeks in IV iron sucrose group and blood transfusion group respectively. Other hematological parameters like reticulocyte count, MCV, MCH, and MCHC also increased significantly after intervention in both groups. However, no significant difference was noticed in the change of hematological parameters in between the groups. ConclusionsThe IV iron sucrose is as effective as blood transfusion in replenishing the hemoglobin and iron storage status in hemodynamically stable women with moderate post-partum anemia. This could be an effective alternative of blood transfusion in treating these patients, especially in resource-poor settings.

EFFECTIVENESS OF IRON SUCROSE AND FERRIC CARBOXYMALTOSE IN THE MANAGEMENT OF POSTPARTUM IRON DEFICIENCY ANEMIA: A SOUTH INDIAN PERSPECTIVE

BACKGROUND: Postpartum iron deciency anemia is considered as one of major public health problem with a high prevalence in developing country like India .It is associated with signicant morbidity. AIM AND METHOD: This perspective observational study was carried out to estimate the safety and effectiveness of iron sucrose and ferric carboxymaltose in treatment of postpartum iron deciency anemia. Total 100 participants diagnosed with postpartum anemia were allotted to receive either iron sucrose complex (n=50) or ferric carboxymaltose (n=50). RESULTS: Hemoglobin improvement was signicantly higher in ferric carboxymaltose than iron sucrose complex group (4.37 vs. 3.85 gm/dl, p&lt;0.001), but rise in ferritin levels was comparable between the groups (116.59 vs. 110.48 ng/ml, p=0.330). Most of the patients tolerated the preparation well, minor side effects were observed in 12% and 48% of cases among iron sucrose and ferric carboxymaltose group respectively CONCLUSION: Even though oral iron is considered as a rst line therapy, it requires a prolonged administration and is associated with suboptimal response due to gastric intolerance and poor compliance. Intravenous iron preparations are safer, more convenient and effective alternative for treatment of postpartum iron deciency anemia.

Comparison of intravenous iron sucrose versus oral iron for the treatment of iron deficiency anaemia in pregnancy

Background: Iron deficiency anemia (IDA) is the most common medical problem in pregnancy. Parenteral iron is a useful treatment, although iron dextran use decreased due to anaphylaxis. Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran. Objective: The aim of this study was to compare the safety and efficiency of intravenous iron sucrose with oral iron administration for the treatment of iron deficiency anaemia in pregnancy. Materials and Methods: 100 women with gestational age between 14 and 35 weeks with iron deficiency anaemia & Haemoglobin between 6-8g/dL were randomised to receive either oral iron (ferrous sulphate) 200 mg thrice daily or required dose of intravenous iron sucrose. Haemoglobin, haematocrit, mean corpuscular volume, reticulocyte count were measured at recruitment and on 2nd week, 4th week and at 37 weeks of gestation. Adverse drug reactions were also noted in both these groups. Results: Haemoglobin values varied significantly with time between the two groups at second week, 4th week and at 37 weeks. The mean difference in mean corpuscular volume from the recruitment value was not significant at 2nd week of treatment. When compared to iron sucrose group, oral iron group had significant gastro-intestinal adverse effects. Conclusion: Intravenous iron sucrose treated iron deficiency anaemia of pregnancy faster, and more effectively than oral iron therapy, with no serious adverse drug reactions.

Comparative efficacy and safety of intravenous ferric carboxymaltose and iron sucrose for iron deficiency anemia in obstetric and gynecologic patients: A systematic review and meta-analysis.

Introduction:Iron deficiency anemia (IDA) is common among obstetric and gynecologic patients. This systematic review aimed to assess the comparative efficacy and safety of commonly used intravenous (IV) iron formulations, ferric carboxymaltose (FCM), and iron sucrose (IS) in the treatment of IDA in obstetric and gynecologic patients.Methods:We systematically searched PubMed, EMBASE, Cochrane CENTRAL, and Google Scholar for eligible randomized controlled trials (RCTs) comparing IV iron replacement using FCM and IS up to October 2019. The primary outcome was to compare the efficacy of FCM and IS, assessed by measuring serum hemoglobin (Hb) and ferritin levels before and after iron replacement. The secondary outcome was to compare the safety of FCM and IS, assessed by the incidence of adverse events during iron replacement. The meta-analysis was performed using RevMan 5.3.Results:We identified 9 RCTs with 910 patients (FCM group, n = 456; IS group, n = 454). Before iron replacement, FCM and IS group patients had similar baseline Hb (mean difference [MD], 0.04 g/dL; 95% confidence interval [CI], −0.07 to 015; I2 = 0%; P = 0.48) and ferritin levels (MD, −0.42 ng/mL; 95% CI, −1.61 to 0.78; I2 = 45%; P = 0.49). Following iron replacement, patients who received FCM had higher Hb (MD, 0.67; 95% CI, 0.25–1.08; I2 = 92%; P = 0.002) and ferritin levels (MD, 24.41; 95% CI, 12.06–36.76; I2 = 75%; P = 0.0001) than patients who received IS. FCM group showed a lower incidence of adverse events following iron replacement than IS group (risk ratio, 0.53; 95% CI, 0.35–0.80; I2 = 0%; P = 0.003). Serious adverse events were not reported in any group.Conclusion:FCM group showed better efficacy in increasing Hb and ferritin levels and a favorable safety profile with fewer adverse events compared with IS group for IDA treatment among obstetric and gynecologic patients. However, this meta-analysis was limited by the small number of RCTs and high heterogeneity.Trial registration:The review was prospectively registered with the International Prospective Registry of Systematic Reviews (https://www.crd.york.ac.uk/prospero/, registration number CRD42019148905).

Comparative study of efficacy of intravenous iron sucrose versus ferric carboxymaltose in the treatment of iron deficiency anaemia

Background: Iron deficiency anaemia (IDA) is a common haematological complication with potentially serious clinical consequences that may require intravenous iron therapy. Parenteral iron therapy results faster and higher replenishment of iron stores and correction of Haemoglobin (Hb) levels with better compliance. The study was to compare the efficacy of intravenous ferric carboxymaltose with intravenous iron sucrose to treat iron deficiency anaemia. Methods: 188 patients were included in the study. 100 patients were given iron sucrose. After a 25 mg test dose on the first infusion only, this was given at a dose of 300 mg by intravenous infusion diluted in 100 ml of normal saline, every alternate day. 88 patients were treated with ferric carboxymaltose at a dose of 500 mg diluted in 100 ml of normal saline by intravenous infusion. Hb level and serum Ferritin of both groups were done before iron therapy and 3 weeks after iron therapy. Results: The mean±SD rise of haemoglobin concentration 3 weeks after iron therapy in iron sucrose group was 11.0±0.61 g/dL, while in ferric carboxymaltose group was 11.2±0.64 g/dL. The mean±SD ferritin 3 weeks after iron therapy in iron sucrose group was 76.0±14.28 ng/mL, while in ferric carboxymaltose group was 80.0±15.16 ng/mL. No serious adverse events were reported in either the ferric carboxymaltose group or iron sucrose group. Conclusions: Ferric carboxymaltose causes higher rise in Hb level as compared to parenteral iron sucrose.

Efficacy and Cost Effectiveness of Intravenous Ferric Carboxymaltose Versus Iron Sucrose in Adult Patients with Iron Deficiency Anemia

Abstract: Objectives: Iron deficiency anemia (IDA) is a major health issues and common type of nutritional deficiency worldwide. For IDA treatment, IV iron is a useful therapy. Many intravenous (IV) iron preparations are used for treatment of iron-deficiency anemia (IDA). The purpose of this study is to evaluate the efficacy of ferric carboxymaltose (FCM) in comparison to iron sucrose (IS) in treatment of IDA adult patients; considering cost-effectiveness (CE) for IDA patients from Qatar healthcare system perspective. We evaluated both treatments considering their response outcomes at 12 months period as well their respective acquisition costs. Methods: This was a cross sectional study with retrospective data performed on 764 IDA adult patients who were treated either with FCM or IS for IDA linking clinical efficacy (defined as improvement in hemoglobin (HB), ferritin and transferrin saturation levels) utility, and CE evaluation, including Incremental Cost-Effectiveness Ratio (ICER) over a 12-months period. The response to treatment was the primary outcomes. As the clinical laboratory data were collected before and after the first injection of the medications. The cost i.e. resources consumed were also the main outcome in our study. The cost effectiveness of FCM and IS was the secondary outcome. Direct healthcare costs were derived from the national healthcare payer system. Both descriptive and differential statistics were applied for data analysis. Alpha = 0.05. Results: Patients in the IS group used significantly higher number of injections, ampoules of medication, NS 0.9% bags and visits to the IV suite compared to FCM group. There were significant changes of laboratory tests between the FCM and IS groups. Further analysis in the change of effectiveness, indicated that the changes of hemoglobin and MCH levels in the IS group were significantly higher than the FCM group. The overall cost of IS therapy was significantly slightly higher than FCM. The medication cost for FCM was approximately 6.5 times higher than IS but cheaper in terms of bed cost and nursing cost. CE ratio illustrated that FCM and IS were significantly different in terms of HB, ferritin and MCH levels. Further, ICER indicated that further justifications and decisions need to be made for FCM when using HB, iron, transferrin saturation, MCH and MCV levels as the surrogate outcomes. Conclusions: The higher cost of FCM versus IS can be offset by savings in healthcare personnel time and bed space. ICER indicated that further justifications and decisions need to be made for FCM when using HB, iron, transferrin saturation, MCH and MCV levels as the surrogate outcomes. Limitations and strengths: Limited data is available with respect to comparison of safety and adverse effects of FCM and IS. The data is reliable as it was collected and documented before and after the treatment. Patients were monitored 30 min after the infusion to ensure keen observation and maximum safety. Disclosures No relevant conflicts of interest to declare.

Randomized clinical trial of IV iron sucrose and IV ferric carboxymaltose in the treatment of moderate iron deficiency anaemia in pregnancy

In India, the national nutritional anaemia control programme (NNACP) was started in 1970 and is being implemented through primary health centers and sub centers. It recommended pregnant women to take one iron tablet per day for at least 100 days (each tablet containing 100 mg of natural iron and 500 mcg of folic acid) after first trimester of pregnancy; a similar dose applies to lactating women. Study Design: Randomized clinical trial. 160 pregnant ladies going to antenatal clinic at 14-36 weeks of gestation with Hb 7- 9.9g%. Who met the inclusion criteria were arbitrarily distributed into two groups. One with odd registration number was given iron sucrose and one with even was given FCM. Hematological profile includes Haemoglobin, Reticulocyte count, Blood indices (MCH, MCHC, MCV) Fringe smear, Serum iron and Serum TIBC. 52% cases from FCM group observed in the age gathering of 21-24 years and 39% cases from Iron Sucrose group were observed in the age gathering of 25-28 years. 54% cases from FCM and 46% cases from Iron sucrose were observed in the gestational Age of 29 to 36 weeks. 43% cases from FCM and 46% cases from Iron sucrose were primigravida. Patients from FCM group and 4 patients from Iron sucrose group did not follow up. 2 pts. From FCM group and 1 pt. from Iron sucrose group refused treatment. The rise in mean Hb level after 1 week and 4 weeks of treatment with FCM is more than Iron sucrose. The rise in mean Sr. Iron level after 1 week and after 4 weeks of treatment with FCM is more than Iron sucrose. The reduction in mean Sr. TIBC level after 4 weeks of treatment with Iron sucrose is more than FCM. The rise in mean MCH, MCHC and MCV levels after 1 week and 4 weeks of treatment with FCM is more than Iron sucrose. There was no serious adverse effect noted in both groups.

Comparative study of iron sucrose versus ferric Carboxymaltose in the management of iron deficiency Anaemia in pregnancy

Objectives: Iron deficiency anemia is the most common hematological but manageable health problem encountered among the pregnant women globally but more common in developing countries like India. Methods: It is interventional prospective comparative study conducted in Department of Obstetrics and Gynaecology at Dr. Yashwant Singh Parmar Govt. Medical College & Hospital Nahan, Sirmour (H.P) over a period of 2years from April 2017- April 2019. 100 pregnant patients with hemoglobin in the range 7gm/dl - 9 gm/dl between 16 to 34 weeks gestation were selected randomly. Patients were divided into two groups 50 each. Group 1 is Iron Sucrose (IS) group- patients were treated with intravenous iron sucrose in multiple doses on alternate days on 0,2,4,6 and 8, 200mg per day, total of 1000mg. Group 2 is Ferric Carboxymaltose (FCM) group were treated with intravenous FCM 1000mg single dose. In both group Hemoglobin and Serum ferritin were assessed before and after (3 & 6 weeks) parenteral therapy.Results: There is significant rise of hemoglobin >2 gm/dl in Group 2 (FCM) as compared to in Group 1 (Iron sucrose). The single dose regime of FCM group was having very good compliance as compared to Iron sucrose group. Conclusion: Intravenous Ferric carboxymaltose is more effective and safer as compared to Intravenous Iron sucrose in the management of anemia during pregnancy.