Liposomal Iron Research Articles

Oral Liposomal Iron Versus Injectable Iron Sucrose for Anemia Treatment in Non-dialysis Chronic Kidney Disease Patients: A Non-inferiority Study.

Introduction Anemia is a prevalent and persistent complication in chronic kidney disease (CKD), particularly in advanced stages, contributing to the deterioration of renal function and diminishing patients' quality of life. Iron supplementation constitutes a cornerstone of anemia management in this population. Among various iron formulations, liposomal iron has emerged as a promising option due to its enhanced efficacy in replenishing iron reserves and improved tolerability. Objective This study aims to assess the comparative effects of intravenous and liposomal oral iron on hemoglobin levels in non-dialysis CKD patients. Additionally, it seeks to evaluate the rate of hemoglobin correction, iron reserve status during treatment, and therapeutic tolerance to these interventions. Materials and methods A randomized controlled trial enrolled CKD patients (stages 3-5, not on dialysis) with iron deficiency anemia (hemoglobin ≤ 12 g/dL, ferritin ≤ 100 ng/mL, transferrin saturation ≤ 25%). Participants were allocated to receive either daily oral liposomal iron (Group OS) at a dosage of 30 mg or intravenous iron-hydroxide sucrose complex weekly (Group IV) for three months. Follow-up extended through the treatment phase and two months post-withdrawal. Results Thirty-one CKD patients were randomized into two groups: 14 received intravenous iron (IV group) and 17 received oral iron (OS group). After excluding four patients, the final cohort comprised 27 individuals (IV group: n=13, OS group: n=14). Both iron treatments resulted in progressive hemoglobin increases, with the IV group showing a mean increase of 14.65% (p=0.049) compared to 4.78% (p=0.003) in the OS group. Secondary analysis revealed significant increases in ferritin levels (p<0.001) and transferrin saturation (TSAT) levels (p=0.031) in the IV group. Post-treatment follow-up demonstrated stable hemoglobin levels in the OS group and a consistent increase in ferritin levels in the IV group. Adverse reactions predominantly included hypotension in the IV group (4 (30.7%)) and constipation in the OS group (4 (28.4%)). Discussion and conclusion Anemia remains a significant challenge in CKD patients. Our study compares oral liposomal iron to injectable iron for anemia treatment, aiming to minimize hospitalizations for iron infusion, preserve venous capital, and mitigate potential harmful side effects. We found oral liposomal iron to be a safe and effective option for correcting anemia in non-dialysis CKD patients, albeit with lower efficacy in replenishing iron stores compared to IV iron. Comparative analysis with similar studies supports the non-inferiority of oral liposomal iron, although IV iron retains superiority in replenishing iron reserves.

Evaluating iron replacement therapies in pediatric CKD: A comparative analysis of oral liposomal iron, iron supported lactoferrin and IV iron Dextran

CKD is defined as longstanding kidney damage and reduction in renal function. The global burden of CKD in the pediatric population is 15 per million, with congenital renal anomalies and hereditary disorders being the primary causes. Of these, 10% of patients require RRT. The development of anemia in chronic disease is a significant concern as the disease progresses. This condition exacerbates the pathological state by increasing the risk of infection, inevitably resulting in mortality. The study aims to establish the comparative analysis of three types of iron replacement therapies including oral liposomal iron, iron supported lactoferrin and IV iron dextran by evaluating their safety and efficacy corresponding to the different stages of CKD in pediatric population. A comparison between all three variants of iron replacement therapy shows oral liposomal iron provides higher bioavailability and tolerance but effective only in lower CKD stages. In IV iron dextran, rapid iron store replenishment has been observed, but with significant side effects, including the risk of severe hypersensitivity reaction. Conversely, oral iron-supported lactoferrin has demonstrated a maximal iron recovery response after six months of therapy, but with frequent gastrointestinal side effects.

#2264 Efficacy and safety of oral iron supplementation with liposomal iron in non-dialysis chronic kidney disease patients with iron deficiency

Abstract Background and Aims Iron deficiency (ID) is very common in patients with non-dialysis dependent chronic kidney disease (NDD-CKD). In these patients, oral iron supplementation is recommended as first-line treatment for ID. However, the efficacy of oral iron supplementation is frequently impaired by a higher incidence of adverse gastrointestinal side effects. Liposomal iron is a compound with ferric pyrophosphate enclosed in a phospholipid nucleus, providing high gastrointestinal absorption and bioavailability and a lower incidence of side effects. However, few data are available on its efficacy in patients with NDD-CKD. Method This single-arm pilot study was carried out in in patients with NDD-CKD stages 1-5 and ID, defined as serum ferritin (SF)&amp;lt;100 ng/mL and/or transferrin saturation (TSAT)&amp;lt; 20%, consecutively seen in two Nephrology units (Naples and Bari) from 01/12/2022 to 01/04/2023. We assessed the efficacy of six months of liposomal iron therapy in correcting ID across three visits after baseline (month 1, 3 and 6). All patients received liposomal iron (30 mg/day twice daily for the first month followed by 30 mg daily for the remaining five months). The primary endpoints were the achievement of SF ≥100 ng/mL and TSAT ≥20%. Secondary outcomes were hemoglobin (Hb) changes and safety of liposomal iron; adherence to the iron supplementation was assessed by monthly pill counting. Changes of continuous variables during the study were analyzed by linear mixed models assuming an unstructured covariance matrix; this was done to take into account the correlation between repeated measures and missing points for patients not completing the study. Change of prevalence of corrected SF and TSAT values from baseline to month 1, 3 and 6 was analyzed by McNemar test. Results 38 patients (65.3 ± 15.2 years, 52.6% males, 35.1% diabetes, eGFR 38.5 ± 28.8 mL/min/1.73 m2) received at least one dose of liposomal iron (safety population). Efficacy population included 34 patients with at least one control visit after baseline. Clinical characteristics of patients enrolled in the two clinics did not differ. In efficacy population, baseline SF was 44 (IQR 19-82) ng/mL and TSAT 14.3 ± 5.9%, corresponding to a percentage of SF&amp;lt;100 ng/mL of 78.9%, and TSAT&amp;lt;20% in 89.5%; 64.7% had both parameters below the cut-offs. Anemia (defined as Hb&amp;lt;12 g/dL in women and &amp;lt;13 g/dL in men) was detected in 22/34 patients. Liposomal iron induced a progressive increase of TSAT from 14.3 ± 5.9%, at baseline to 20.0 ± 7.6% at month-6 (P = 0.009) whereas no difference was detected for SF (Fig. 1A and 1C). Accordingly, at the end of study, the prevalence of TSAT&amp;gt;20% significantly increased from 11.8% to 50.0% (P = 0.002) while correction of SF, mildly improved (from 23.5% to 30.0%, P = 0.214, Fig. 1B and 1D). When patients were stratified by anemia, a significant improvement of TSAT was observed in anemic patients (from 13.3 ± 5.8% to 20.2 ± 8.1%, P = 0.012), whereas no significant improvement was found in patients without anemia (P = 0.093). Adherence to iron supplementation was 100% in patients completing the study. Hb values did not significantly increase at month-6 in either anemic (+0.60 ± 1.39 g/dL, P = 0.258) or non-anemic (+0.08 ± 0.78 g/dL, P = 1.0) patients. In safety population (n = 38), 7 patients dropped out (18.4%). In particular, treatment was discontinued in 4 patients in the first month (2 for diarrhea, 1 for dyspepsia and constipation, and 1 for death), 1 patient after 3 months (switch to intravenous iron for symptomatic anemia), and 2 after five months (1 for dyspepsia and 1 for death). Conclusion The use of liposomal iron in patients with NDD-CKD is associated with a partial correction of functional ID (TSAT&amp;lt;20%), with no significant effect on iron storage. The small sample size prevents any causative conclusion, though it may provide some insights into using these compounds in patients with CKD.

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.

Comparative Efficacy of Ferrous, Ferric and Liposomal Iron Preparations for Prophylaxis in Infants

Comparative Efficacy of Ferrous, Ferric and Liposomal Iron Preparations for Prophylaxis in Infants

In vitro studies of a novel liposomal formulation for safe and efficient iron delivery

AbstractAnemia of chronic diseases is the most popular type of anemia. Treatment of such conditions is based on iron supplementation. However, chronic conditions are accompanied by increased activity of hepcidin, which significantly limits iron absorption from traditional supplementation forms. Modern liposomal technologies allow for efficient encapsulation of macromolecules, which can result in a significant absorption improvement. The presented results show an encapsulation efficiency of more than 90% of iron‐dextran complexes, with a decrease in cytotoxicity and reactive oxygen species generation.Practical Application: These results can be used to prepare novel liposomal iron ion formulation with high encapsulation efficiency due to the appliance of iron(III) oxide complex with dextran.

Oral Liposomal Iron: A Promising New Strategy for Anemia Management in Clinical Practice

Anemia is a public health problem affecting about a third of the world’s population, the major cause of it being iron deficiency. The many oral iron preparations available at present, are inadequate due to intolerance, or contraindications. IV iron preparations are painful, require patient monitoring and carry the risk of anaphylaxis. Iron salts like Iron pyrophosphate are covered with liposome, a spherical structure of a phospholipidic nature that is similar to those human cell membranes. The bioavailability of liposomal pyrophosphate iron is 3.5 times greater than the free pyrophosphate iron, 2.7 times higher than iron sulfate, and 4.1 times higher compared with iron gluconate. Clinical studies showed that oral liposomal iron is a safe and efficacious alternative to correct anaemia, as also it is a viable treatment option for iron deficiency anaemia in pregnant women.

Liposomal Iron Oxide Nanoparticles Loaded with Doxorubicin for Combined Chemo-Photothermal Cancer Therapy

Iron oxide nanoparticle (IONP) possesses unique advantages over other nanoparticles in the use of cancer imaging and therapy. Specifically, it has drawn great attention in the emerging research field of photothermal cancer therapy. Herein, we developed doxorubicin (DOX)-loaded liposomal IONP (Lipo-IONP/DOX) and evaluated in vitro and in vivo their applicability for combined chemo-photothermal cancer therapy. The Lipo-IONP was synthesized by the thin-film evaporation method. The prepared Lipo-IONP was observed as about a 240 nm-sized agglomerate of globular-shaped nanoparticles. The TEM and FT-IR data evidenced the successful formation of liposomal IONP. The superparamagnetic property of the Lipo-IONP was confirmed by the SQUID analysis. The DSC data showed a transition temperature of about 47-48 °C for the mixed lipids composing the Lipo IONP, and the DOX release studies revealed the feasibility of induced burst release of DOX by laser irradiation. The Lipo-IONP/DOX possessed a plasma half-life of 42 min, which could ensure sufficient circulation time for magnetic tumor targeting. The in vivo magnetic targeting enabled a significant increase (6.3-fold) in the tumor accumulation of Lipo-IONP/DOX, leading to greater photothermal effects. Finally, the preliminary efficacy study evidenced the applicability as well as the safety of the Lipo-IONP/DOX for use in combined chemo-photothermal cancer therapy. Overall, the study results demonstrated that the Lipo-IONP/DOX might serve as an effective and safe agent for combined chemo-photothermal cancer therapy.

Оценка эффективности сукросомальной формы железа при лечении пациенток с железодефицитной анемией 1–2-й степени тяжести на фоне обильных менструальных кровотечений

Aim: to evaluate the clinical efficacy of Sucrosomial® iron (SiderAL® Forte) in the treatment of stage 1–2 iron deficiency anemia (IDA) in patients with menorrhagia in the setting of ovulation disorders. Patients and Methods: a prospective randomized multicenter clinical case study of 110 patients with stage 1–2 IDA developed in the setting of menorrhagia as a result of ovulation disorders was conducted. Female patients of the main group (n=74) received Sucrosomial® iron 30 mg 2 times a day for 60 days. In the control group (n=36), a liposomal iron preparation of 30 mg 2 times a day was also prescribed for 60 days. Results: during Sucrosomial® iron ferrotherapy, an increase in Hb levels by more than 20 g/L was observed after 30 days of administration in 65 (87%) female patients, after 60 days in 73 (98.6%) female patients, which demonstrated higher therapeutic efficacy versus liposomal iron preparation (69.4 and 88.8%, respectively, p=0.0001). There was also a greater adherence to therapy (98.6%) during Sucrosomial® iron intake versus liposomal iron intake (86.1%, p=0.0001), due to fewer (1.4%) adverse events compared with the control group (5.5%, p=0.0002). Conclusion: oral ferrotherapy with Sucrosomial® iron is a reasonable option for the IDA treatment in patients with menorrhagia due to its higher efficacy versus the liposomal iron. The effect occurs after 30 days of drug intake with a minimum number of adverse events, due to the unique structural, physico-chemical and pharmacokinetic characteristics of the sucrosomial iron, thanks to which it is protected from the gastric juice action, does not contact with the gastrointestinal mucosa and is absorbed through special intestinal M-cells with further iron release in liver cells. KEYWORDS: iron deficiency anemia, menorrhagia, ovulation disorders, Sucrosomial® iron, women, therapy. FOR CITATION: Kononova I.N., Dobrokhotova Yu.E., Kareva E.N., Shmakova N.A., Graban I.V., Ogurtsova T.A. Evaluation of the sucrosomial iron efficacy in the patient treatment with stage 1–2 iron deficiency anemia during heavy menstrual bleeding. Russian Journal of Woman and Child Health. 2023;6(4):332–339 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-2.

Quality of life in Anemic Patients with Inflammatory Bowel Disease

INTRODUCTION: Anemia is a common complication in inflammatory disease bowel (IBD). Many patients have this comorbidity ignored during clinical follow-up. Nonetheless, studies of anemic patients have a significant relationship between anemia and low quality of life. This study evaluated the quality of life before and after treatment for anemia in mild anemic, IBD patients from the IBD Center of the UFJF University Hospital. OBJECTIVE: The objective of the present study was to investigate the improvement of quality of life after treatment of anemia in IBD patients. METHODS: In this cross-sectional study, 100 patients with CD (Crohn's disease) and 100 with RCUI (ulcerative colitis) were screened for anemia. For evaluation of anemia, complete blood count, ferritin, saturation index transferrin, serum levels of folic acid, serum iron and vitamin B12 was performed. In anemic patients, was evaluated and compared the levels of quality of life before and after anemia treatment. For the evaluation of quality of life, the disease-specific quality of life (QOL) was acessed. RESULTS: The baseline IBDQ score for the cohort was 157 (±37) with a mean increase in the score by 26.4 (P &lt;0.001) at week 8 compared to the baseline. CONCLUSION: Treatment with oral liposomal iron was effective in improving the treatment of anemia in IBD Brazilian outpatients showed statistically significant improvement in quality of life of patients with inactive or mildly active IBD.

Improvement of Anxiety, Depression and fatigue after treatment of Anemia in patients with inflammatory bowel disease patients

INTRODUCTION: Anemia is a common complication in inflammatory disease bowel (IBD). Many patients have this comorbidity ignored during clinical follow-up. Nonetheless, studies of anemic patients have a significant relationship between anemia and higher anxiety, depression and fatigue. This study evaluated the level of anxiety, depression and fatigue before and after treatment for anemia in mild anemic, IBD patients from the IBD Center of the UFJF University Hospital. OBJECTIVE: The objective of the present study was to investigate the improvement of anxiety, depression and fatigue after treatment of anemia in IBD patients. METHODS: In this cross-sectional study, 100 patients with CD (Crohn's disease) and 100 with RCUI (ulcerative colitis) were screened for anemia. For evaluation of anemia, complete blood count, ferritin, saturation index transferrin, serum levels of folic acid, serum iron and vitamin B12 was performed. In anemic patients, was evaluated and compared the levels of anxiety, depression and fatigue before and after anemia treatment. For the evaluation of anxiety was applied the hospital anxiety and depression scale (HADS), to assess fatigue was applied Chalder`s questionnaire. RESULTS: The evaluation average for anxiety before anemia treatment was 7.3 ± 4.3 and after treatment it was 5.3 ± 4.8 (p=0.0.08), the average of depression before treatment was 6.2 ± 5.2 and after treatment it was 4.9 ± 4.8 (p=0.08) and the average of fatigue before anemia treatment was 30.9 ± 8.7 and after treatment it was 21.6 ± 8.4 (p&lt;0.001). Treatment with oral liposomal iron was effective in improving mild IDA and quality of life, as well as in decreasing fatigue in patients with inactive or mildly active IBD. CONCLUSION: The treatment of anemia in patients with IBD Brazilian outpatients showed statistically significant improvement in cases of anxiety and fatigue, although did not demonstrate a significant improvement in depression.

POS-238 THE SAFETY AND THE EFFECTIVENESS OF THE LIPOSOMAL IRON ON THE TREATMENT FOR IRON DEFICIENCY ANEMIA IN PEDIATRIC PATIENTS WITH CHRONIC KIDNEY DISEASE IN HEMODIALYSIS

Anemia is a frequent complication of chronic kidney disease (CKD) and is associated with a decrease in the life quality of patients, as well as an increase in morbidity and mortality. Iron deficiency is common in CKD patients and can cause anemia and lack of response to erythropoietin-stimulating agents (ESAs), so it must be corrected to ensure optimization of erythropoiesis. Iron can be administered by different routes, each with its advantages and disadvantages. Liposomal iron, a new generation oral iron with high gastrointestinal absorption and bioavailability and a low incidence of side-effects.

Ferrodeficiency and pregnancy: what to do and when to begin?

In September 2021, an online webinar took place on the most common nutritional deficiency in the world – iron deficiency. According to the WHO recommendations, women should definitely receive iron and folic acid, starting with the stage of pregravid preparation, during pregnancy and lactation. Other trace elements and vitamins during pregnancy must be substantiated by evidence of their deficiency. WHO recommendations (2017) for antenatal care indicate that daily oral iron supplementation 30–60 mg and folic acid 400 µg in pregnant women can reduce the incidence of postpartum sepsis, preterm birth and low birth weight. Daily iron supplementation 60 mg should be preferred in regions where the prevalence of anemia in pregnant women ≥ 40%. In the first and third trimesters anemia is diagnosed by Hb level &lt; 110 g/l, in the second trimester by Hb level &lt; 105 g/l. If anemia is detected the iron dose is doubled until Hb reaches ≥ 110 g/l, after which the prophylactic dose is resumed. Iron supplements 120 mg once a week and folic acid 2800 µg once a week are recommended if daily intake of iron supplements is not possible due to side effects, and the prevalence of anemia in pregnant women does not exceed 20%.Modern Lipofer® technology in the development of liposomal iron delivery (when iron transported by liposomes) solved the problem of low bioavailability and poor tolerance, which is inherent in most ferrum drugs. As a result, iron trapped in liposomes (liposomal iron) does not come into contact with the mucous membranes of the gastrointestinal tract, but binds to chylomicrons, which enter the blood through the lymph, where iron is freed from the liposome. This way of absorption reduces iron loss, allows using of smaller doses and helps to avoid side effects.

Liposomal ferric pyrophosphate and ascorbic acid supplementation in pregnant women with iron deficiency anaemia: haematochemical, obstetric, neonatal and psychological outcomes in a prospective observational study

This study aimed to determine the effects of liposomal iron pyrophosphate/ascorbic acid on clinical and psychological outcomes in pregnant women. Women at the 11th–13th weeks of gestation with iron deficiency anaemia assuming Sideremil™ from April 2018 to May 2019 were recruited. Haematochemical, obstetric, neonatal and psychological outcomes were investigated at the enrolment, 21–23 weeks of gestation, 30–32 weeks of gestation and after 6 weeks from childbirth. Results showed significant positive effects on haemoglobin, ferritin, sideremia and transferrin levels, compared to baseline data. A significant improvement of anxiety and depression levels was also observed. Regarding the quality of life, all the domains significantly improved, especially the Physical Role domain. Our results indicate that Sideremil™ may be a valid treatment for iron deficiency anaemia in pregnant women, since it significantly improves haematological and mental health outcomes. However, further studies are needed to confirm these results.

Evaluation of the Impact of Iron Deficiency Anemia during Pregnancy on Hospital Admission and Utilization of Hospital Resources in Latifa Women and Children Hospital, Dubai, UAE

Introduction: Iron deficiency anemia (IDA) is endemic among pregnant females worldwide. Liposomal iron preparation is a novel therapy for treating IDA in pregnant females. There is a lack of research on cost-effect and comparison between various new iron preparations as liposomal and intravenous (IV) iron supplements in the international literature. Objective: The objective of this study was to evaluate the cost-effect and maternal-fetal outcome of IDA during pregnancy in Latifa Women and Children Hospital, Dubai, UAE. Design: The study was a quasi-experimental study. Settings: Settings include tertiary-care hospital settings affiliated with academic center in UAE. Patients and Methods: A total of 226 pregnant women were inducted in the study who were controlled in terms of age, BMI, baseline hemoglobin (Hb), severity of anemia, and ferritin levels. There were 116 patients who received oral liposomal iron pyrophosphate and 110 patients received IV iron saccharate complex for 4 weeks. The overall cost-effect and maternal-fetal outcomes were compared in 2 groups. Main Outcomes Measured: The main outcomes measured the cost-effect of liposomal and IV iron therapy, and the 2 treatments were compared in terms of maternal and fetal outcomes. Result: The subjects were matched for age and body mass index and showed that the patients in the IV group were more symptomatic than those in the oral group (18.1 vs. 31.9% p value <0.01). There was no statistically significant difference among women from different nationalities living in UAE (p value 0.079). There were 98 (84.4%) patients in the oral group and 99 (90%) patients in the IV group who achieved the desired Hb levels after 1 month of treatment (p value = 0.878). Moreover, the side effects were also comparable in both groups (1.72 vs. 1.82% p value = 0.56). The incremental cost-effect ratio for IV iron was USD 108,633/rise to desired Hb. Conclusion: Liposomal iron preparations may be cost-effective and have fewer side effects than IV iron. In terms of outcome, the maternal and fetal variables are comparable in liposomal and IV groups.

Роль інноваційної ліпосомальної форми пірофосфату заліза в корекції порушень транспорту кисню у представників олімпійських циклічних видів спорту (результати рандомізованого подвійного-сліпого плацебо-контрольованого дослідження)

Today, sports anemia occurs in elite sports quite often, although it is not a disease (does not apply to ICD-10), but only a pathological condition. Sports anemia is characterized by changes in the red link of the blood, and it is associated with a decrease in the content of erythrocytes and / or hemoglobin. However, this condition leads to a significant decrease in physical performance, and, consequently, the effectiveness of the competitive activity of representatives, first of all, of cyclic sports. Athletes are more sensitive to the effects of anemia and iron deficiency than people who are not constantly exposed to intense physical activity, since performance depends on the maximum oxygen consumption and utilization of active muscles. Sports anemia is often iron deficient, as well as B12 and folate deficient. Therefore, the assessment of various factors accompanying the development of anemia and the development of technologies for the correction of this pathological condition is an important task of sports laboratory diagnostics, as well as pharmacology and nutritional science of sports. Material and methods. We conducted a randomized, double-blind, placebo-controlled study to assess the safety and effectiveness of the effect of a course use of the Santeferra dietary supplement containing liposomal ferric iron in the form of pyrophosphate, vitamins B9, B12 and ascorbic acid on the results of training activities of representatives of cyclic sports with predominantly an aerobic energy supply mechanism. In the course of a dynamic study, which lasted 60 days, the parameters of hematological homeostasis and accumulation, metabolism and transport of iron (content of serum iron, transferrin, ferritin, folic acid, iron binding capacity of serum, saturation of transferrin with iron), as well as the level of serum erythropoietin and the severity of oxidative stress were assessed directly in the membranes of erythrocytes. In parallel, we determined the indicators of aerobic endurance: the absolute and relative values of the maximum oxygen consumption and the PWC170 value. Results and discussion. We found out that in the study sample of 67 athletes who specialized in sports with aerobic energy supply (running disciplines of athletics, rowing and canoeing, triathlon, cross-country skiing), 19 (28.35%) had manifestations of sports anemia, and 23 (34.32%) had latent iron deficiency, which also negatively effect on their physical performance. The course application of Santefrerra, 1 capsule per day for 60 days, helped to normalize the accumulation, transport and metabolism of iron, as well as to significantly reduce the manifestations of oxidative stress that occurs under the influence of prolonged physical exertion. In athletes with anemia and latent iron deficiency, practically no changes in the content of erythropoietin in the blood serum were found. At the end of the course of taking a dietary supplement, the indicators of the relative maximum oxygen consumption in the athletes of the main group increased by 11.5% (P &lt;0.05) and the results of the PWC170 test by 11.4% (P &lt;0.05) which displays predominantly aerobic endurance. In the placebo-control groups, we noted no positive dynamics in indicators of the red link of hematological homeostasis and the accumulation, metabolism and transport of iron, as well as the parameters of the prooxidant-antioxidant balance directly in the erythrocyte membranes during the 60-day observation period. Indicators of aerobic endurance also remained unchanged. Conclusion. Thus, the course using Santeferra is not accompanied by the development of side effects and is effective for the treatment of iron deficiencies in athletes

A few steps before ..., or how to protect a pregnant woman from iron deficiency and anemia. Literature review

The article presents modern data on the etiology, pathogenesis, diagnosis, prevention and treatment of iron deficiency anemia (IDA) and anemia of chronic disease, as well as their combination on the eve of and during pregnancy. The emphasis is made on the role of iron deficiency of any etiology in the development of obstetric and perinatal complications, especially its impact on the central nervous system formation and further psychophysical child development. Need for prevention of iron deficiency states in risk groups which includes all women of reproductive age who have menstruation is shown based on evidence-based medicine data. Effectiveness and safety of modern drugs containing iron in oral and parenteral forms has analyzed. The paper presents data on the safety and effectiveness of an innovative form of ferric iron in the form of liposomal iron, which differs in the mechanism of action, digestibility and the absence of side effects typical for this group of drugs.According to various authors the frequency of IDA in pregnant women ranges up to 80%, in puerperas up to 40%. It is unimpossible to stop IDA without iron supplementation only with an iron-rich diet. Two main groups of iron preparations are used to correct iron deficiency differing in the valence of iron atoms – bivalent iron salts and trivalent complexes. These drugs differ in the tolerability and bioavailability of atomic iron. Liposomal iron is a new drug for treatment of iron deficiency and IDA today; it has an innovative way of iron delivery to the body. Liposomal iron has advantages for the prevention of anemia in patients with anemia of chronic disease or its combination with IDA (inflammatory bowel diseases, obesity, after resection of the stomach and intestines, etc.). An innovative form of liposomal iron in Ukraine is represented by a dietary supplement Ferroview containing 30 mg of elemental iron, that is corresponds to the average prophylactic dose recommended in WHO documents

FOR A FEW STEPS TO..., OR HOW TO AVOID FOR IRON DEFICIENCY AT PREGNANCY. LITERATURE REVIEW

The article presents modern data on the etiology, pathogenesis, diagnosis, prevention and treatment of iron deficiency anemia (IDA) and anemia of chronic disease, as well as their combination on the eve of and during pregnancy. The emphasis is made on the role of iron deficiency of any etiology in the development of obstetric and perinatal complications, especially its impact on the central nervous system formation and further psychophysical child development. Need for prevention of iron deficiency states in risk groups which includes all women of reproductive age who have menstruation is shown based on evidence-based medicine data. Effectiveness and safety of modern drugs containing iron in oral and parenteral forms has analyzed. The paper presents data on the safety and effectiveness of an innovative form of ferric iron in the form of liposomal iron, which differs in the mechanism of action, digestibility and the absence of side effects typical for this group of drugs. According to various authors the frequency of IDA in pregnant women ranges up to 80%, in puerperas up to 40%. It is unimpossible to stop IDA without iron supplementation only with an iron-rich diet. Two main groups of iron preparations are used to correct iron deficiency differing in the valence of iron atoms – bivalent iron salts and trivalent complexes. These drugs differ in the tolerability and bioavailability of atomic iron. Liposomal iron is a new drug for treatment of iron deficiency and IDA today; it has an innovative way of iron delivery to the body. Liposomal iron has advantages for the prevention of anemia in patients with anemia of chronic disease or its combination with IDA (inflammatory bowel diseases, obesity, after resection of the stomach and intestines, etc.). An innovative form of liposomal iron in Ukraine is represented by a dietary supplement Ferroview containing 30 mg of elemental iron, that is corresponds to the average prophylactic dose recommended in WHO documents.

Liposomal iron in moderate chronic kidney disease

Introduction and objectiveThe optimal iron supplementation route of administration (intravenous vs. oral) in patients with chronic kidney disease (CKD) not on dialysis is a hot topic of debate. An oral preparation (liposomal iron, FeSu) has recently been developed with high bioavailability and low incidence of side effects. The objective was to evaluate the efficacy of FeSu in patients with stage 3 CKD and gastrointestinal intolerance to conventional oral iron therapy. Material and methodsProspective observational study of patients with stable stage 3 CKD and gastrointestinal intolerance to conventional oral iron therapy. An oral 30mg/day dose of FeSu was administered for 12 months. The primary outcome measure was hemoglobin increase at 6 and 12 months. Treatment adherence and adverse effects were also evaluated. Results37 patients aged 72.6±14.7 years and with an estimated glomerular filtration rate (eGFR) of 42±10mL/min/1.73m2 were included. 32 patients had received previous treatment with conventional oral formulations, 73% of which exhibited gastrointestinal intolerance with treatment adherence of 9.4%. After 6 months with FeSu, an increase in hemoglobin was observed versus baseline, which was sustained at 12 months (0.49±0.19 and 0.36±0.19g/dL, respectively, p<0.05), despite a significant eGFR decrease of 3.16±1.16 and 4.20±1.28mL/min/1.73m2 at 6 and 12 months, respectively. None of the patients experienced adverse reactions that required the treatment to be suspended. Adherence was 100% at both 6 and 12 months. ConclusionsFeSu is effective in a cohort of patients with stage 3 CKD with similar characteristics to the general population of moderate CKD patients, with a low rate of adverse reactions and excellent tolerability.

A Novel Approach for Iron Deficiency Anaemia with Liposomal Iron: Concept to Clinic

Iron deficiency anaemia is the most common nutritional deficiency disorder, contributing to 50 percent of all the anaemias in the world. Dietary changes alone are insufficient for the correction and management of iron deficiency anaemia. Hence, iron supplementation is necessary. Conventional oral iron therapy is limited in many patients because of dose dependent side effects, insufficient absorption, lack of compliance and limitation in various inflammatory conditions. Liposomal iron is a technologically designed, innovative form of iron which due to its differential delivery system ensures higher absorption and bioavailability, greater tolerability and least gastro-intestinal side effects unlike conventional oral iron preparations. This review provides a critical discussion and a comprehensive view based on the author’s review of the medical literature concerning the technology of liposomal iron preparation, mechanism of its absorption, its advantage over conventional iron preparations and clinical evidence on its usage in iron deficient states in pregnancy and certain inflammatory conditions.