Background and Aim: Iron deficiency (ID) is a common condition worldwide, affecting about one-third of the population, and is particularly prevalent in heart failure (HF) patients. In HF, ID worsens symptoms such as fatigue and shortness of breath, contributing to higher hospitalization rates and mortality. Intravenous (IV) iron therapies like Ferric Carboxymaltose (FCM) and Ferric Derisomaltose (FDI) have effectively enhanced symptoms and improved quality of life. This meta-analysis examines the safety and efficacy of these iron treatments. Methods: A comprehensive literature search was conducted using PubMed, Clinical Trial.gov, and Cochrane Library databases from inception to May 2024 to identify relevant studies. All statistical analyses were conducted using R statistical software version 4.1.2. Our protocol was registered with PROSPERO (CRD#CRD42023469246). Our study included Randomized Controlled Trials (RCTs). The primary outcomes of our study includes major adverse events such as Cardiovascular Mortality, All-Cause Death, heart failure hospitalization rate, KCCQ, LVEF, MLHFQ3, and Peak Oxygen Consumption (pVO2). Results: Twenty-four RCTs with 11,333 participants were analyzed. The pooled analysis indicated that All-cause mortality risk reduction was observed with FCM [RR=0.89; 95% CI: 0.75–1.04] and FDI [RR=0.95; 95% CI: 0.81–1.12]. FCM significantly reduced composite outcomes of hospitalization for HF or cardiovascular mortality [HR=0.74; 95% CI: 0.59–0.93], while FDI showed modest effects [HR=0.86; 95% CI: 0.56–1.26]. Kansas City Cardiomyopathy Questionnaire scores improved notably with FCM [MD=5.21; 95% CI: 2.22–8.19]. Left Ventricular Ejection Fraction improvement was highest with Iron Sucrose [MD=2.92; 95% CI: 1.61–4.21]. For the Minnesota Living with Heart Failure Questionnaire (MLHFQ), Iron Sucrose also showed the most improvement [MD = -18.00; 95% CI: -38.52 to 2.52], followed by FCM and FDI. In peak oxygen consumption (pVO2), FCM exhibited modest benefits [MD = 1.25; 95% CI: -2.34 to 4.84]. The six-minute walk test (6MWT) results identified Ferrous Sulphate as the most effective [MD = 53; 95% CI: -18.85 to 124.85], followed by FCM. Conclusion: This highlights Ferric Carboxymaltose as a promising iron therapy for heart failure patients with iron deficiency. However, clinical decisions should consider patient factors, tolerability, and cost-effectiveness. Further long-term studies are needed to optimize treatment and prevent hospitalization.

Introduction: Iron deficiency (ID) is common in HF and is associated with adverse CV outcomes. There is a paucity of literature on efficacy of intravenous iron replacement (FeIV) in children with HF. Methods: Single-center observational analysis of 244 children (≤ 21 years old) with HF or post-heart transplant (HTX) who received IV iron sucrose (IS, 46%) from 2010-2018 or IV ferric carboxymaltose (FCM, 54%) from 2019-2024. Anemia was defined by World Health Organization age-specific hemoglobin cutoffs; ID was defined as iron saturation (TSAT) <20% or ferritin <100 ng/mL. Primary outcome was change in iron profile and hematological indices. Secondary outcome was change in LVEF and BNP. Exploratory outcome included baseline risk factors for anemia and composite event of HTX listing, need for MCS, or death by latest follow-up. Results: Median age at first FeIV infusion was 3.6 years (IQR 0.8-13.2); 43% were female. Diagnoses included CDM (49%), congenital heart disease (43%), and s/p HTX (8%). Total of 812 FeIV infusions were administered (67% IS; 33% FCM). Median number of infusions per patient was 4 (IQR 3–6) for IS and 1 (IQR 1–2) for FCM (p<0.01). Despite fewer infusions, the median cumulative dose was higher with FCM (19.9 vs 13.1 mg/kg; p<0.01). At baseline, 82% had TSAT <20%, 70% had ferritin <100 ng/mL, 38% had serum iron <40 mcg/dL, and 50% were anemic. Only 56% had TSAT <20% with ferritin <100 ng/mL. Mean follow-up was 255 days (SD±144). Significant increases in TSAT, ferritin, serum iron, hemoglobin, and LVEF, and decreases in BNP, were observed at most follow-up points (Table 1) (all p<0.05). Following FeIV, 81% achieved TSAT ≥20% and 80% ferritin ≥100 ng/mL. Composite event occurred in 28% at median 28 days (IQR 8-102) following first FeIV infusion; time to event occurred significantly earlier in IS vs FCM cohorts (18 vs 32 days, respectively, p=0.04). Multivariable analysis identified ferritin <100 ng/mL was independently associated with decreased risk of anemia and serum iron <40 mcg/dL as increased risk (Table 2). Older era (2010-2018), lower cumulative FeIV dose, ferritin <100 ng/mL, lower TSAT, and higher BNP were all independently associated with higher risk of composite event (Table 3). Conclusion: FeIV effectively corrects ID in children with HF and may be linked with improvements in clinical outcomes. Further studies are needed to confirm safety and clinical benefits of FeIV in pediatric HF.

Background: Randomized trials, including AFFIRM-AHF, show that intravenous (IV) iron improves functional status and reduces hospitalizations in patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency. However, real-world evidence remains limited. We aimed to assess these outcomes in a large, multicenter electronic health record network. Methods: We conducted a retrospective, propensity score-matched cohort study using the TriNetX Global Collaborative Network. Adults with HFrEF and iron deficiency or anemia (ferritin ≤100 ng/mL or hemoglobin ≤11 g/dL) were included. Patients with prior malignancy, ESRD, erythropoietin exposure, or blood transfusion were excluded. IV iron exposure included iron sucrose, ferric carboxymaltose, ferric gluconate, ferumoxytol, iron dextran, and ferric derisomaltose. Matching was 1:1 on demographics, comorbidities, and therapies, yielding two balanced cohorts (n=62,318 each). Outcomes were assessed over two years. Results: IV iron therapy was associated with a modestly increased risk of supraventricular tachycardia (HR 1.15, 95% CI 1.08–1.22, p<0.001) and ventricular tachycardia (HR 1.11, 95% CI 1.05–1.17, p<0.001), but not atrial fibrillation/flutter (HR 0.98, 95% CI 0.93–1.03, p=0.985). No significant differences were observed in blood transfusion, PCI, or CABG rates. The IV iron group had significantly lower rates of elevated high-sensitivity C-reactive protein (hs-CRP ≥3 mg/L; HR 0.82, 95% CI 0.74–0.91, p<0.001), with no difference in NT-proBNP elevations. Cardiac outcomes—including cardiac arrest, acute heart failure, myocardial infarction, cardiomyopathy, and new-onset ejection fraction <20%—did not differ significantly. IV iron therapy was associated with reduced all-cause hospitalization (HR 0.74, 95% CI 0.71–0.78, p<0.001), while emergency and outpatient visit rates were similar. All-cause mortality was not significantly different (HR 1.02, 95% CI 1.00–1.04, p=0.120). Conclusion: In this large, real-world cohort of HFrEF patients with iron deficiency, IV iron therapy reduced hospitalizations and inflammation (hs-CRP), with no effect on mortality or most cardiac outcomes. A modest increase in SVT and VT was observed. These findings support guideline recommendations for IV iron in HFrEF and highlight the need for arrhythmia monitoring.

Understanding the kinetics of macrophage uptake and the metabolic fate of iron-carbohydrate complexes used for iron deficiency anemia treatment.

Iron supplementation protects against renal ischemia-reperfusion injury by enhancing mitochondrial respiratory complex assembly.

Abstract Background and Aims Anemia due to reduced renal erythropoietin (EPO) production, abnormal iron metabolism, and increased blood loss is common in patients receiving hemodialysis (HD). Guidelines recommend correcting iron deficiency before starting EPO-stimulating agents in chronic kidney disease (CKD). Intravenous (i.v.) iron is preferred over oral (p.o.) supplements for better bioavailability and tolerability but may increase infection risk and cause severe allergic reactions. Sucrosomal-coated oral iron has demonstrated improved tolerability and bioavailability compared to its oral equivalents. This trial compared the efficacy and tolerability of p.o. sucrosomal iron to i.v. iron sucrose in patients receiving HD. It also assessed monocyte subset distribution and proinflammatory potential between i.v. and p.o. iron supplementation and compared to healthy subjects, as it has been hypothesized that free iron, as in i.v. iron supplementation, could increase the pro-inflammatory tendencies of patients with CKD. Method This was a single center, single blinded, cross over, randomized placebo controlled trial, conducted from January 2020 to September 2023 at the center for HD of the University Hospital of St Pölten. A total of 28 patients with stable iron status (ferritin ≥100 ng/ml and transferrin saturation 20%–50%) under i.v. iron supplementation were included in the trial and randomized to group A (daily p.o. sucrosomal iron and weekly i.v. placebo during HD) or group B (daily p.o. placebo and weekly i.v. iron sucrose during HD). After 24 weeks, the treatments were switched and the trial continued for 24 weeks. At 4-weekly visits, laboratory values and patient charts were reviewed and participants completed questionnaires about study medications’ side effects and kidney disease-related quality of life. Results In the intention-to-treat population, ferritin levels were significantly higher at 24 weeks in patients receiving i.v. iron sucrose (487.7 vs. 847.5 ng/ml, P = 0.02). In the per-protocol population, ferritin levels increased under i.v. iron sucrose, the difference was not statistically significant (508.9 vs. 856 ng/ml, P = 0.06). Hemoglobin and transferrin saturation (TSAT) levels did not significantly differ between p.o. and i.v. iron supplementation at any of the visits. TSAT levels fell below 15% or ferritin levels fell below 100ng/ml more frequently in participants taking sucrosomal iron p.o., the difference was not statistically significant (15.4% vs. 11.1%, P = 1). All other parameters remained stable across visits and were similar in i.v. and p.o. supplementation. Significantly more participants reported having dark stools while taking p.o. supplementation (16.1% vs. 0%, P = 0.03). More participants withdrew their participation in the study due to gastrointestinal side effects while taking p.o. supplementation, the difference was not statistically significant (26.92% vs. 11.11%, P = 0.27). The frequency of further adverse events was similar for both study medications. The type of iron supplementation (p.o. vs. i.v.) neither influenced monocyte subset distribution, levels of platelet-derived EVs (pEVs)-monocytes aggregates, nor ferroportin expression. In comparison to healthy subjects, patients receiving HD showed a shift in the relative abundance of monocyte subsets towards intermediate monocytes (CD14++CD16+) and non-classical monocytes (CD14+CD16++), higher levels of pEV-monocyte aggregates and increased monocytic production of IL-6 and TNF after stimulation with lipopolysaccharide Conclusion Oral sucrosomal iron is a safe alternative to i.v. iron sucrose for iron supplementation in patients receiving HD. Hemoglobin, ferritin and TSAT levels should be checked regularly. Its main side effects are of gastrointestinal nature. The monocytes of patients receiving HD showed stronger pro-inflammatory tendency than those of healthy subjects, regardless of the type of iron substitution they received.

Transfusions of packed red blood cells (RBC) have long been used to correct postpartum anaemia. Given the ongoing shortage of packed RBC and transfusion reactions, we sought to determine if the use of IV iron sucrose infusions could decrease transfusions in the postpartum period. We conducted a six-year quasi-experimental interrupted time series study from January 2016 to December 2021. The study was divided into three phases: 1. pre-intervention phase, 2. roll-out phase, and 3. post-intervention phase. Our intervention focused on a holistic transfusion prevention bundle that incorporated provider education regarding transfusion practices, antepartum optimization, and cell saver use. The main outcome was change over time from the use of IV iron sucrose over allogenic blood products in the setting of postpartum anaemia. Statistical process control (SPC) was used to explore the effect of our bundled intervention over time. 46 478 deliveries were recorded. The XmR control chart showed a shift between phases 1 and 3, as indicated with a special cause signal. The U control chart demonstrated that IV iron infusions increased from 5.6 per 1000 births in phase 1 to 136.4 per 1000 births in phase 3. On Poisson regression, the rate of IV iron sucrose infusions increased 19-fold [RI 19.65 (95% CI 16.00-24.14 p < 0.0001)], while the rate of transfusions decreased by 60% [RI 0.4 (95% CI 0.33-0.49 p < 0.001)] from pre- to post-intervention. A holistic transfusion prevention bundle was associated with both a reduction in the number of patients transfused and the rate of multiple-unit RBC transfusions.

Analysis of Lactoferrin vs. Intravenous Iron Sucrose in Treating Iron Deficiency Anemia During Pregnancy

Anemia among expectant mothers is a major health issue worldwide, especially in developing countries, where prevalence reaches 37%. Various interventions, such as micronutrient supplementation and intravenous iron administration, have been widely implemented. However, limited systematic reviews have comprehensively evaluated both the cost-effectiveness and feasibility of such interventions in low- and middle-income countries (LMICs). This study aims to systematically evaluate recent evidence on the feasibility and cost-effectiveness of anemia management interventions for pregnant women in developing countries. The review followed the 2020 PRISMA guidelines and was registered in PROSPERO (CRD420251089753). Article searches were conducted across five primary databases (CINAHL, CENTRAL, PubMed, Wiley, and Taylor &amp; Francis) for publications between 2015 and 2025. Study selection was performed independently by six authors. Seven studies meeting the inclusion criteria were analyzed narratively. The findings indicated that interventions such as Multiple Micronutrient Supplementation (MMS) and Intravenous Iron Sucrose (IVIS) were highly cost-effective, demonstrating Incremental Cost-Effectiveness Ratios (ICERs) substantially lower than the willingness-to-pay threshold (USD 653–1,792 per DALY) in developing nations, including Indonesia. Feasibility of implementation was influenced by healthcare system capacity, logistical resources, educational initiatives, and sociocultural contexts. Overall, MMS and IVIS interventions demonstrated superior efficiency and effectiveness compared to conventional therapies, though their success relies on system readiness and contextual adaptation. This review fills a critical evidence gap by jointly assessing cost-effectiveness and real-world feasibility, providing a strong foundation for designing sustainable, evidence-based strategies to manage anemia in resource-limited settings.

Introduction: Anemia is common in hemodialysis patients, and iron supplementation is essential for its management. However, the impact of baseline inflammation on the efficacy of oral versus intravenous iron remains unclear. Methods: This post hoc analysis of the IHOPE trial included 193 maintenance hemodialysis patients stratified by median baseline high-sensitivity C-reactive protein (hsCRP). Patients were randomized to receive intravenous iron sucrose (100 mg once biweekly) or oral polysaccharide-iron complex (150 mg twice daily) for 24 weeks. The primary outcome was hemoglobin level at 24 weeks. Secondary outcomes included hsCRP, oxidative stress markers, and iron parameters. Results: At 24 weeks, patients with high baseline hsCRP had lower hemoglobin levels than those with low hsCRP (113.82 ± 12.04 vs. 118.05 ± 13.50 g/L, p = 0.038), despite similar baseline hemoglobin values. Among patients receiving intravenous iron sucrose, those with high hsCRP had significantly lower hemoglobin (112.90 ± 13.19 vs. 121.32 ± 13.46 g/L; p = 0.005) and higher hsCRP and superoxide dismutase levels, suggesting persistent inflammation and oxidative stress. In contrast, hemoglobin levels were similar between high and low hsCRP subgroups in the oral polysaccharide-iron complex group (p = 0.913). Iron parameters and adverse events were comparable across groups. Conclusion: This post hoc analysis suggests baseline inflammation significantly modifies responses to specific iron formulations in hemodialysis patients. Patients with elevated hsCRP showed poorer hemoglobin responses to intravenous iron sucrose, while oral polysaccharide-iron complex maintained consistent efficacy across inflammatory states. These findings warrant prospective studies on inflammation-guided personalization of iron therapy.

Objective: To determine the efficacy of parenteral iron carboxy-maltose (FCM) versus iron sucrose complex (ISC) for the treatment of postpartum iron-deficiency anemia (IDA).Methods: A randomized controlled trial was conducted among postpartum women with IDA. Primary outcome was to compare the efficacy of FCM versus ISC in the improvement of hemoglobin (Hb), RBC indices (mean corpuscular Hb (MCH), mean corpuscular volume (MCV), mean corpuscular Hb concentration (MCHC)), and iron stores (serum iron, serum ferritin, percentage saturation of iron, and total iron binding capacity). Secondary outcomes were side-effect profile and maternal complications. At enrolment, 500 women were randomized to two groups. Demographic and clinical data were collected at enrolment and four weeks later.Results: Women receiving FCM had statistically significantly higher Hb levels (g/dl) (11.4 (10.3-12.5) vs. 11 (9.1-12.9), p<0.001), better RBC indices (MCV (fl); 96.5 (87.5-105) vs. 92 (77-107), p<0.001, MCH (pg/cell); 32 (27-37) vs. 30 (25-35), p<0.001, MCHC (g/dl); 36 (31-41) vs. 34 (30-38), p=0.001) and better iron stores (serum ferritin (µg/l); 290 (273-307) vs. 229 (213-245), p<0.001, and percentage saturation of iron (%); 24.5 (16.5-32.5) vs. 21 (16-26), p<0.001). However, there was no difference regarding serum iron (p=0.513) and total iron binding capacity (p=0.298). ISC had poor compliance as 23 (9.2%) women did not come for repeated doses. Secondary outcomes (side-effect profile (p=0.797) and maternal complications (p=0.176)) were comparable among women.Conclusion: Ferric carboxymaltose has better efficacy and compliance for the treatment of postpartum iron-deficiency anemia as compared to iron-sucrose complex, with a similar side effect profile. We recommend that women with postpartum iron deficiency anemia (Hb 7-11 g%) receive at least a single parenteral FCM (1000 mg) before discharge from the hospital as a standard policy, especially in low- and middle-income countries.

Abstract BackgroundIron‐deficiency anemia (IDA) affects over one‐third of pregnant patients globally, contributing to severe maternal morbidity and adverse neonatal outcomes. Oral iron supplementation, while cost‐effective, is limited by poor absorption, significant gastrointestinal side effects, and poor adherence. The use of intravenous (IV) iron addresses many of these concerns, including eliminating GI side effects and the need for daily therapy. However, administration of IV iron in pregnant patients is typically restricted to specialized infusion centers or hospitals due to concerns about acute side effects, cost, resource utilization, the need for fetal heart rate monitoring, and extended infusion times.MethodsThis descriptive study evaluated the implementation, safety, and feasibility of outpatient IV iron infusions for pregnant patients with IDA, with maternal hemoglobin response and outcomes reported as secondary findings. Patients received a single or series of doses of IV iron spaced weekly, with hemoglobin levels monitored before and after treatment. No fetal heart tracing was performed. Antepartum patients treated with IV iron at our outpatient obstetric clinic from 2017 to 2024 were identified retrospectively, and their charts were reviewed.ResultsA total of 417 pregnant patients received IV iron (87.3% iron sucrose; 12.7% Ferric Carboxymaltose); 65.9% received ≥600 mg total dose (2–3 dose protocol), while 34.1% received lower cumulative doses (1–2 infusions). Therapy was well‐tolerated with no anaphylactic reactions reported. Side effects were experienced in only 11.5% of patients and were relatively minor, with dizziness (6.2%), headache (1.9%), and hypotension (1.7%) being the most common. Adverse maternal outcomes (PPH, ICU admission, blood transfusions, and re‐admissions) were low, particularly in patients who received the last infusion more than 10 days before delivery. Neonatal outcomes included a 7.4% NICU admission rate and a 3.5% rate of infants weighing less than 2500 g. Mean hemoglobin increased by 1.5 g/dL, consistent with prior studies.ConclusionThis study demonstrates that IV iron therapy can be safely given in obstetrical clinics without significant maternal or fetal safety concerns. This obviates the need for more resource‐intensive and costly settings such as infusion or hospital‐based centers.

Pregnancy is associated with increased risk for the development of iron deficiency anemia. Pregnant patients with anemia are at increased risk for significant morbidity and mortality. Iron therapies for the correction of anemia during pregnancy are available in intravenous and oral formulations; however, the cost-effectiveness of these therapies in the United States has not been previously evaluated. The objective of this study is to estimate the cost-effectiveness of oral and intravenous iron therapies as treatments for prepartum anemia in the United States.We constructed a Markov decision-analytic model to evaluate the cost-effectiveness of three common therapies for repleting iron in patients with prepartum anemia in the United States: oral iron, intravenous iron sucrose, and intravenous ferric carboxymaltose. Each strategy differentially modified the proportion of patients with anemia at time of delivery by the therapeutic efficacy of each treatment option demonstrated in the literature. Outcomes of interest included net costs, quality-adjusted life-years, and adverse outcomes averted. Costs were considered from the health system and societal perspectives over a lifetime time horizon for a hypothetical cohort of 3.8 million pregnant patients. Deterministic and Monte Carlo probabilistic sensitivity analyses were conducted to evaluate the robustness of the model.All iron therapies were dominant versus the "do nothing" strategy in the majority of simulations, implying that they were simultaneously more effective and cost-saving. Ferric carboxymaltose produced the most favorable results overall, with $696,920,137 in cost-savings and 26,660 postpartum hemorrhage cases, 888 hysterectomies, and 43 postnatal suicides averted per cohort. Threshold analysis suggested that oral iron was cost-saving below a threshold of $14.40 per 325 mg, and iron sucrose and ferric carboxymaltose were cost-saving below thresholds of $1996.86 and $2,893.97 per course, respectively.Our findings suggest that treating prepartum anemia with currently available iron therapies would result in significant cost-savings and reductions in adverse outcomes associated with anemia in this context. Ferric carboxymaltose likely confers the greatest overall benefit among competing options. This conclusion is robust to parameter uncertainty, even when the cost of these therapies is significantly higher than demonstrated in the literature. · Oral and intravenous iron therapies are likely cost-effective for the treatment of antepartum anemia.. · Intravenous ferric carboxymaltose is likely the most clinically and economically favorable treatment.. · This is the first U.S. estimate of the cost-effectiveness of oral and intravenous iron for antepartum anemia..

Tumor microenvironment (TME)-responsive nanoparticles have garnered significant attention in the biomedical field due to their tumor-specific properties, which enable precise drug-controlled release for enhanced therapeutic efficacy and markedly improved safety in the in vivo application of anticancer drugs. Herein, a self-assembled nanoparticle ICT, capable of intelligently controlling thrombin release, is fabricated via a facile one-step assembly of thrombin, iron sucrose, and the photosensitizer Chlorin e6 (Ce6), followed by surface modification with DSPE-mPEG-cRGD to enhance tumor-targeting capability. The as-synthesized smart nanoassembly exhibits inherent fluorescence quenching, but its fluorescence imaging properties can be rapidly restored under the weakly acidic and glutathione (GSH)-overexpressed tumor microenvironment. Upon cellular internalization, the ICT nanoparticles are promptly degraded in the tumor microenvironment, releasing thrombin to induce rapid tumor vessel embolization. Concurrently, the liberated iron sucrose elevates hemoglobin levels in vivo, amplifying the embolization effect, while the generated Fe2+ delivers a lethal blow to tumor cells through chemodynamic therapy and modulates the tumor immune microenvironment. The ICT nanoparticles not only achieve safe in vivo delivery of thrombin but also establish a multifunctional nanotheranostic system for tumor treatment via tumor-specific fluorescence imaging.

BackgroundIron deficiency anaemia (IDA) is the most prevalent nutritional deficiency among children globally. Intravenous (IV) iron serves as an alternative treatment for paediatric patients with poor response to oral iron therapy. However, data on the use of IV iron sucrose treatment in Chinese children remain limited.MethodsThis retrospective study evaluated 40 paediatric patients with IDA (≤ 18 years) treated with IV iron sucrose at Beijing Children’s Hospital (July 2022-December 2023). Demographic, clinical, and laboratory parameters were analysed before and after therapy.ResultsAmong the paediatric patients, 22 were male, 18 were female, and 19 were adolescent children older than 12 years. The average haemoglobin concentration increased from 75.6 g/L to 124.9 g/L, and the haematological response rates at both 4 and 8 weeks post-IV treatment were 100% and 97.5%, respectively. The average MCV increased from 67.6 fL to 82.4 fL, and the mean MCH increased from 18.8 pg to 26.5 pg. The mean MCHC increased from 276.2 g/L to 315.3 g/L. The median ferritin level increased from a pre-IV median of 5 ng/ml to a post-IV median of 85.9 ng/ml. Similarly, the serum iron level increased from a pre-IV median of 2.3 µmol/L to a post-IV median of 14.5 µmol/L. The mean TSAT increased appropriately from 2.9% pre-IV to 22.4% post-IV. A total of 36/40 children had a ferritin value greater than 30 ng/ml post-IV. The incidence of adverse reactions was 2.5% (1/40).ConclusionIV iron sucrose is safe and effective for Chinese paediatric patients with IDA who are unresponsive to oral iron.

Ferric Derisomaltose Versus Iron Sucrose in Pregnancy (FLIP): A Retrospective Observational Study on Outpatient Intravenous Iron Infusion Capacity.

Determination of free iron content in pharmaceutical products containing different iron complexes by using polarography method: "Method development and validation study".

ABSTRACTObjective:To compare the efficacy of administration oral versus infusions intravenous iron (IV) therapy in diabetic patients with chronic kidney disease (CKD) receiving Erythropoietin.Methods:This retrospective comparative study, including 144 diabetic and CKD patients (72 in each group) was conducted at Northwest General Hospital, Peshawar, by reviewing patient records from January 2020 to December 2024. Patients with complete medical records were included consecutively. Group-A was given oral ferrous sulfate (200mg twice daily) for four weeks, whereas Group-B was given intravenous iron sucrose infusion once weekly for the same period. The efficacy was measured in-terms of iron deficiency anemia. The analysis was performed using IBM-SPSS-25. Due to the retrospective design, it inherits the bias of missing data, however exclusion criteria was strictly followed to minimize this bias.Results:The baseline characteristics, including age, gender, ferritin levels, and CKD stage, were similar across both groups. After four weeks of iron therapy, 24(33.3%) of patients showed improvement in Group-A while 44(61.1%) of patients in Group-B (p=0.001). Sub-Group analyses revealed that Group-B patients show significantly higher improvement in males, older (56-70) years patients, and longer diabetes duration (p<0.001). Stage-5 CKD patients showed better outcomes with IV iron (p<0.001).Conclusion:IV iron therapy was significantly more effective and show superior efficacy in older patients, males, and those with longer diabetes mellitus duration than oral therapy in improving anemia-related complications in diabetic patients with CKD receiving Erythropoietin, making it a preferable treatment choice in this population.

Iron deficiency has been associated with heart failure severity and mortality in children and adults. Intravenous iron therapy has been associated with improved outcomes for adults with heart failure. However, little is known about its impact and safety in children. We performed a single-centre review of all intravenous iron sucrose infusions prescribed to hospitalised patients ≤ 21 years of age with a primary cardiac diagnosis from 2020 to 2022. Ninety-one children (median age 6 years, weight 18 kg) received 339 iron sucrose infusions with a median dose of 6.5 mg/kg [5.1 mg/kg, 7.0 mg/kg]. At initial infusion, the majority (n = 63, 69%) had CHD, 70 patients (77%) were being managed by the advanced cardiac therapy team for heart failure, 13 (14%) were listed for heart transplant, 32 (35%) were on at least one vasoactive infusion, and 5 (6%) were supported with a ventricular assist device. Twenty infusions (6%) were associated with 27 possible infusion-related adverse events in 15 patients. There were no episodes of anaphylaxis or life-threatening adverse events. The most common adverse events were hypotension (n = 12), fever (n = 5), tachycardia (n = 3), and nausea/vomiting (n = 3). Eight of 20 infusion-related adverse events required intervention, and two infusions were associated with escalation in a patient's level of care. Following intravenous iron repletion, patients' serum iron, serum ferritin, transferrin saturation, and haemoglobin increased (p < 0.05 for all). In children hospitalised with cardiac disease, intravenous iron sucrose repletion is safe and may improve haemoglobin and iron parameters, including transferrin saturation and ferritin levels.

Aim: The study aims to evaluate the effectiveness and safety of intravenous iron sucrose in correcting serum ferritin in female patients with iron deficiency anemia. Materials and Methods: A prospective clinical study was conducted at Alsader Medical City in AlNajaf City/ Iraq. We enrolled 100 female patients with iron deficiency anemia, and hemoglobin less than 12 mg/dl. Two hundred mg of elemental iron was given twice weekly over 2.5 hours, and the patients were observed closely for any potential side effects. The main effectiveness endpoint gained from variation in serum ferritin and hemoglobin from baseline to end of the study. The safety evaluation includes recording any side effects developed either during or after intravenous administration. Results: The mean of hemoglobin concentration at bassline was 8.05±0.891 mg/dl, and the mean of hemoglobin after one month of treatment was 11.234±1.232G/dl,(p <0.0001). There was an increase in serum ferritin concentration from the beginning of the study with 10.2±0.23ng/dl to 224.12±0.772 ng/dl, (p<0.0001) after 1 month of treatment. No one of the patients had any serious or lethal side effects. Conclusions: Intravenous iron sucrose is an effective and safe option for the correction of serum ferritin in female patients with iron deficiency anemia.