Management Of Iron Deficiency Anemia Research Articles

Bridging the Knowledge Gap on Iron Deficiency Anemia Among Nursing Students

Background: Iron deficiency anemia (IDA) is a prevalent nutritional disorder characterized by a significant reduction in the body’s iron stores, affecting oxygen transport and leading to various health complications. Specific Background: The understanding of IDA among nursing students is underdeveloped, especially regarding the differences between morning and evening study cohorts. Knowledge Gap: Understanding nursing students' knowledge of IDA is critical for enhancing educational strategies and improving patient care, yet limited studies have assessed this demographic's awareness of the condition and its management. Aims: This study aims to evaluate nursing students' knowledge about IDA and to compare the levels of knowledge between morning and evening students at the College of Nursing, University of Basrah, over a six-month period from November 2023 to March 2024. Results: A descriptive cross-sectional study was conducted involving 145 students (72 morning and 73 evening) who completed a questionnaire. Results indicated that 40.2% of morning students and 53.4% of evening students suffered from iron deficiency. While 86.1% of morning students had prior knowledge of IDA compared to 67.1% of evening students, the mean knowledge levels were deemed good for both groups, with no significant statistical difference between them. Novelty: This research contributes to the existing literature by highlighting knowledge levels of IDA among nursing students in Iraq, revealing that both morning and evening cohorts possess substantial understanding yet exhibit slight discrepancies. Implications: The findings underscore the necessity for targeted educational interventions to bridge the knowledge gap regarding IDA, ultimately enhancing nursing students' competencies in managing this condition in clinical settings. Highlights: IDA Prevalence: 40.2% morning students and 53.4% evening students affected. Knowledge Difference: 86.1% morning vs. 67.1% evening students aware of IDA. Educational Need: Targeted interventions required for improved IDA management in nursing education. Keywords: Iron deficiency anemia, nursing students, knowledge assessment, educational interventions, Iraq

Standardizing the evaluation and management of iron deficiency anemia secondary to heavy menstrual bleeding in the emergency department.

Comprehensive guidelines for the management of iron deficiency anemia (IDA) in adolescents with heavy menstrual bleeding (HMB) presenting to the emergency department (ED) are lacking, leading to variability in care. We aimed to standardize the evaluation and management of these patients through the development and implementation of an evidence-based algorithm using quality improvement methodology. Baseline data of the target population identified variability across four key measures of clinical management: therapy choice and administration, laboratory evaluation, hematology service consultation, and patient disposition. Literature review and consensus from pediatric hematology and gynecology providers informed a draft algorithm that was refined in an iterative multidisciplinary process. From December 2022 to July 2023, we aimed to achieve a 25% relative increase in patients to receive optimal management per the algorithm, while using sequential Plan-Do-Study-Act (PDSA) cycles. Process measures focusing on provider documentation and balancing measures, such as ED length of stay, were assessed concurrently. Forty-nine patients were evaluated during four PDSA cycles. Improvement of ≥40% above baseline regarding recommended therapy administration was achieved across four PDSA cycles. Adherence to recommended therapy choice improved from 57% (baseline) to 100%, minimal laboratory evaluation from 14% to 83%, hematology consultation from 36% to 100%, and appropriate disposition from 71% to 100%. ED length of stay remained stable. Implementation of a standardized algorithm for management of IDA secondary to HMB in adolescents in the ED increased adherence to evidence-based patient care.

Enhancing referral practices: A bariatric department's education initiative to reduce unnecessary referrals to hematology oncology.

82 Background: Bariatric surgery patients face an elevated risk of iron deficiency anemia. Referrals from the Bariatric department to Hematology Oncology for work up of these anemias strain clinic resources and delay timely care for cancer patients. We initiated a targeted education program to reduce unnecessary referrals from the Bariatric department to Hematology Oncology by raising awareness among staff about appropriate referral criteria. Methods: We developed a curriculum highlighting the differences between symptoms of bariatric surgery complications and hematologic malignancies. Interactive training sessions were held with Bariatric department staff, supplemented by informational materials. Case studies and real-world examples reinforced understanding and decision-making. Staff were also educated on managing iron deficiency anemia internally. Referral rates were tracked before and after the intervention. Results: Baseline data were collected from July 2023 to November 2023, showing an average of 17 referrals per month (85 total over 5 months). The educational initiative included three sessions in December 2023 on anemia management and referral criteria. These sessions highlighted the distinction between symptoms of bariatric complications and hematologic malignancies, as well as education to the bariatric surgery providers on management of hematologic diagnoses resulting from bariatric surgery. Post-intervention data from January 2024 to May 2024 showed a substantial reduction in referrals for bariatric-related iron deficiency anemias to an average of 4.4 referrals per month (22 total over 5 months), indicating a 74% reduction. Improved internal management of iron deficiency anemia contributed to this outcome. The percentage of cancer patients receiving a consult within 7 days of referral contemporaneously improved from 85.7% to 88.1%, indicating improved access to oncology care. Conclusions: The educational intervention significantly reduced unnecessary referrals from the Bariatric department to Hematology Oncology, improving access for cancer patients. Empowering staff with the knowledge to make informed referral decisions and manage common hematologic issues internally improved patient care and clinic efficiency, reducing healthcare costs and patient burden in both departments.

High internal phase Pickering emulsions co-loaded with astaxanthin and ferrous gluconate improve iron deficiency anemia in mice and their applications in 3D printing

Iron deficiency anemia (IDA) is a prevalent and serious nutritional health issue that can be mitigated through dietary iron supplementation. However, only ferrous ions, prone to oxidation, can be absorbed in the gastrointestinal tract. In the current work, the effects of high internal phase Pickering emulsions (HIPPEs) co-loaded with astaxanthin (ASTA) and ferrous gluconate on Fe2+ oxidation, IDA management, and their 3D printing performance were investigated. The results demonstrated that the HIPPEs co-loaded with ASTA and ferrous gluconate effectively reduced the oxidation rate of Fe2+ during storage. Animal studies also revealed that HIPPE co-loaded with ASTA and ferrous gluconate had a therapeutic effect on IDA symptoms in mice. HIPPE co-loaded with ASTA and 400 mg/L ferrous gluconate demonstrated superior efficacy in restoring hemoglobin (Hb) levels, organ coefficients, and histological parameters in mice with IDA. Moreover, the evaluation of the adaptability of HIPPEs co-loaded with ASTA and ferrous gluconate for food 3D printing indicated a slight reduction in printing resolution. Overall printing performance was found to be acceptable and satisfactory. Co-loading ASTA and ferrous gluconate in HIPPEs offers an efficient way to address the oxidation challenge of ferrous ion supplementation, enabling customization and flexibility in the production of iron-fortified foods to mitigate IDA.

A Study on the of Nutrition, Health and Hygiene Counselling impact on Iron Deficiency Anaemia

Iron deficiency anemia (IDA) is a prevalent nutritional disorder, especially among women and children in developing countries. This study investigates the impact of nutrition, health, and hygiene counseling on the prevalence and management of iron deficiency anemia. Through a combination of dietary modifications, health education, and hygiene practices, the study aims to evaluate improvements in hemoglobin levels and overall health outcomes. Participants included women of reproductive age and children from a rural community, who were provided with structured counseling sessions over six months. Baseline and post-intervention data on hemoglobin levels, dietary intake, and hygiene practices were collected and analyzed. The results demonstrate significant improvements in hemoglobin levels and a reduction in the incidence of IDA, highlighting the effectiveness of comprehensive counseling as a sustainable intervention strategy.

Prevalence and management of iron deficiency anemia in pregnancy in a tertiary care hospital over a period of 2 years

Background and Objectives: Anemia in pregnancy is highly prevalent and can have a significant effect on both maternal and fetal outcome. The most prevalent kind of nutritional anemia that occurs during pregnancy is iron deficiency anemia. Even with the use of oral iron prevention during pregnancy, IDA remains a significant health concern for expectant mothers. The current study intends to examine the treatment response and prevalence of IDA in a pregnant population. Methods: This is a retrospective cohort study looking into the prevalence of iron deficiency anaemia amongst pregnant women who delivered in a Tertiary care Hospital for a period of 2 years (Feb2022- Jan2024). All patients who got prenatal care at our hospital had their hemoglobin levels regularly evaluated at booking and at 28 weeks and 36 weeks pregnant and more often as needs by either a venous or capillary blood sample, are included in the inclusion criteria. We use the mid-trimester hemoglobin level to identify patients who are anemic among our study volunteers. SPSS was used for analysis. Results- the prevalence of anemia was found to be 59.4% (N=297) mostly being Iron deficiency anemia. 6 patients were Thalassemia minor and 1 patient was Sickle cell carrier The most common age group was found to be 20-35 years in which 60.2% were anemic. Around 59% of anemic had tertiary form of education and parity 63% for 2-4. The most common category was mild anemia (82%), moderate in 15%. After 36 weeks the anemia levels were improved in all category only 12.4% had mild while no severe anemia was seen. But this was not statistically significant (p>0.05). The incidence of PPH were 2.7% in treated anemic patients while 1.7% in anemic Conclusion: Anemia in Pregnancy is highly prevalent and if left untreated can have a significant effect on both Maternal and fetal outcome. Prevention, Health education on reproductive health from early childhood and Adolescent age is highly recommended.Eraly diagnosis and Prompt management of anaemia in Pregnant females by oral Iron or Iron infusion helps in a better outcome . Parenteral iron therapy should be used as soon as possible to enhance treatment outcomes. And also helps in avoiding the need for Blood transfusion.

Advances in Iron Deficiency Anaemia Management: Exploring Novel Drug Delivery Systems and Future Perspectives.

Iron Deficiency Anaemia (IDA) is a prevalent global health issue characterized by inadequate iron levels in the body, leading to impaired red blood cell production and subsequent anaemia. Traditional treatment approaches for IDA, such as oral iron supplementation, often encounter challenges related to poor compliance, gastrointestinal side effects, and variable absorption rates. As a result, there is a growing interest in exploring novel drug delivery systems to enhance iron therapy efficacy and patient outcomes. This review discusses recent advances in IDA management, focusing on developing and utilizing innovative drug delivery systems for iron supplementation. Various strategies, including nanoformulations, microparticles, liposomes, and hydrogels, are explored for their potential to improve iron bioavailability, reduce adverse effects, and optimize therapeutic outcomes. Furthermore, promising strategies for the future management of IDA are explored, including the utilization of advanced technologies such as targeted drug delivery systems, controlled release mechanisms, and combination therapies. The integration of these novel drug delivery systems with advancements in diagnostics, personalized medicine, and patient-centered care holds great potential to revolutionize the management of IDA and improve the quality of life for individuals affected by this condition.

Efficacy of a pre-operative anaemia clinic in patients undergoing elective abdominal cancer surgery.

Pre-operative iron deficiency anaemia (IDA) is common in patients undergoing elective major abdominal surgery and is associated with increased risk of perioperative complications. However, widespread implementation of pre-operative anaemia management is lacking. Guidelines recommend investigation of anaemia preferably 4-6 weeks before surgery to allow time for correction. However, this is not always feasible in abdominal cancer surgery with short time to surgery and may be influenced by concomitant chemotherapy. The objective of this study was to assess the efficacy of implementing a pre-operative screening and treatment programme for IDA in elective abdominal cancer surgery patients, with short duration to surgery and concomitant use of chemotherapy. All patients scheduled for elective abdominal cancer surgery with IDA were included. Anaemia was defined according to the World Health Organization-criteria and iron deficiency as a transferrin saturation <0.20. The primary outcome was change in haemoglobin (Hb) between iron infusion and surgery in patients receiving pre-operative intravenous iron infusion. Of 178 diagnosed IDA patients 134 (75%) received intravenous iron, 103 pre-operatively (58%) at median day 17 (interquartile range: 9-27) before surgery while 31 (17%) received post-operative intravenous iron treatment. The pre-operative Hb increased 0.89 g/dL (95% CI: 0.64-1.13, p < .001) compared to a decrease of 0.4 g/dL (95% CI: 0.19-0.58, p < .001) in 75 patients not treated pre-operatively. Patients diagnosed with severe anaemia had the largest pre-operative Hb increase. Iron infusion >2 weeks pre-operatively resulted in a greater Hb increment of 1.13 g/dL (95% CI: 0.81-1.45) compared to iron infusion ≤2 weeks before surgery 0.48 g/dL (95% CI: 0.16-0.81). Hb increased by 0.64 g/dL (95% CI 0.19-1.21) in patients receiving chemotherapy ≤31 days prior to surgery. In patients scheduled for abdominal cancer surgery, including in patients with concomitant chemotherapy, pre-operative IDA management is feasible and results in a significant pre-operative Hb increase compared to patients not treated. On the day of surgery 25% patients treated pre-operatively were no longer anaemic.

Ferric carboxymaltose: A game changer in the management of iron deficiency anaemia in pregnancy.

A single-arm prospective cohort (before-after) study among 60 antenatal women with moderate to severe anaemia in the second and third trimesters was conducted from December 2020 to December 2022, and the eligible women were given 1000 mg of intravenous FCM injection. Efficacy was assessed by rate of improvement in haemoglobin and ferritin at 2 weeks post infusion. Safety analysis was done by assessing adverse drug reactions and foetal heart monitoring during the infusion. A total 60 antenatal women with a median gestational age of 32.5 weeks at presentation received 1000 mg of intravenous FCM. There was a rise in mean haemoglobin from 8.05 gm% pre-infusion to 10.93 gm% 2 weeks post infusion, showing a mean rise of 2.88 gm%. Similar improvement was noted in mean serum ferritin levels from 25.92 pre-infusion to 253.96 post FCM infusion. There were no reports of drug-related major adverse effects in the mother or the foetus. FCM is found to be safe and effective treatment with rapid replenishment of haemoglobin and ferritin levels in a single dose, which makes it suitable and compels consideration as the first choice for treatment of iron-deficiency anaemia.

Clinical management of iron deficiency anemia in Japan: iron prescription patterns, treatment effectiveness, and assessments

Iron deficiency anemia is one of the most common types of anemia, but real-world clinical management practices in Japan are unclear. This study retrospectively explored iron prescription patterns, treatment effectiveness, and assessments. Patients with at least one treatment period between September 2020 and September 2022 were included and classified into three groups (ferric carboxymaltose [FCM]: 7437 patients, saccharated ferric oxide [SFO]: 98,648 patients, and oral iron: 359,547 patients). Iron-related laboratory values over time and testing proportions were evaluated. Median baseline hemoglobin levels were lowest with FCM (FCM: 8.10 g/dL, SFO: 8.70 g/dL, oral iron: 9.70 g/dL), but changes in hemoglobin levels by 12 weeks were greatest with FCM (FCM: 3.20 g/dL, SFO: 2.60 g/dL, oral iron: 1.70 g/dL). The median serum ferritin level at 8 weeks after FCM treatment was 43.70 ng/mL for ≤500 mg, versus 123.30 ng/mL for >500 to ≤1500 mg. All groups had a low proportion of serum ferritin and transferrin saturation (TSAT) testing at diagnosis (<38%), which decreased further for post-treatment assessment (<24%). This study suggests the importance of prescribing an appropriate total iron cumulative dose per the package insert, along with diagnosis and assessments based on serum ferritin/TSAT.

Management of iron deficiency anemia during pregnancy: a midwife-led continuity of care model

BackgroundGlobally, 36.5% of pregnancies are affected by anemia, particularly in low-and middle-income countries, posing significant risks to maternal and perinatal health. In rural Pakistan, 44.3% of pregnant women suffer from iron deficiency, contributing to the high prevalence of anemia. Limited accessibility to antenatal care exacerbates the challenge, necessitating innovative solutions. This study assessed a midwife-led continuity of care model, utilizing intravenous (IV) iron therapy for the management of anemia in Karachi, Pakistan.MethodsWe performed a retrospective analysis of data from a prospective cohort study conducted in two primary healthcare facilities, which employed a community midwife (CMW)-led continuity of care model for antenatal care, including IV iron therapy. We extracted data from February 2021 to March 2022 for women who were diagnosed with anemia based on hemoglobin (Hb) levels, categorized as mild (10.0 to 10.9 g/dL), moderate (7.0 to 9.9 g/dL), or severe (less than 7.0 g/dL). Assessment occurred at the initial antenatal care (ANC) visit to establish baseline anemia severity, and approximately 2 weeks after intravenous (IV) iron therapy administration to evaluate post-treatment changes were considered.ResultsWe enrolled 114 pregnant women, where the majority presented with moderate (88.6%) anemia. After IV iron treatment, 48.5% improved to normal-mild levels, while 50% remained unchanged. Severe anemia affected 10.5% at baseline; 42% shifted to moderate and 50% to normal-mild post-treatment, with one remaining unchanged (p &amp;lt; 0.001). Among women enrolled in the first and second trimesters, severe anemia improved to normal-mild (50%) and moderate levels (50%) (pre-treatment: n = 10, post-treatment: n = 0), and moderate anemia decreased by 48% (pre-treatment: n = 92, post-treatment: n = 47).ConclusionOur midwife-led model of care demonstrated an improvement in iron levels among pregnant women. The model addressed the challenges of anemia prevalence in Pakistan and underscored the significance of empowering front-line healthcare providers, such as community midwives (CMWs) for managing these common conditions.

Role of Intravenous Iron in Current Era

Iron is an essential trace mineral necessary for life, and iron deficiency anaemia (IDA) is one of the most common haematological problems worldwide. Oral iron replacement therapy is a simple, inexpensive treatment option for the treatment of iron deficiency in stable patients, but there are many populations for whom IV iron is more effective. Therefore, IV iron should be considered when there are no contraindications, when poor response to oral iron is anticipated, when rapid hematologic responses are desired. Third generation intravenous (IV) iron therapies allow rapid and complete replacement dosing without the toxicity issues inherent with older iron preparations. This review provides an updated overview on diagnosis and management of IDA in patients with chronic conditions, preoperative and considers the properties of the different IV irons, and how differences might impact current and future clinical practice. We will discuss the benefits and limitations of oral versus intravenous iron replacement. Keywords: Anaemia; Intravenous Iron; Iron Deficiency; Oral Iron

Management of iron deficiency anemia in pregnancy in India: A review of current practices and challenges

Iron deficiency anaemia (IDA) is a major global health concern that can lead to difficulties for both the mother and the foetus, especially in pregnant women. The physiological demand of iron during pregnancy increases threefold to support fetoplacental development and maternal adaptation to pregnancy. This study aimed to identify gaps in current IDA management, limitations of conventional oral iron therapy, and the need for effective and well-tolerated treatments.The objective of this study was to understand the gap of current treatment options in IDA management, its limitations, and possible effective strategies for better management.A questionnaire-based opinion survey involving top gynecologists across India was conducted. The survey aimed to gather data on the challenges faced with conventional oral iron therapy, the desire for a change in oral iron salts, and the preference for novel oral iron prescriptions for their patients.Data obtained from the survey showed that 82% of gynecologists and obstetricians noticed challenges with conventional oral iron therapy. 86% wanted to change the oral iron salts, and 70% would like to prescribe novel oral iron for their patients. Ferric maltol, a novel form of chelated oral iron, was introduced as a potential solution for IDA management. It has been studied in various clinical indications, such as IDA associated with inflammatory bowel disease, chronic kidney disease, and pulmonary hypertension, showing significant improvements in hemoglobin and iron indices with good tolerability throughout treatment duration.The study results demonstrate that ferric maltol is a suitable and convenient treatment option for individuals seeking long-term, convenient, and well-tolerated management of IDA.

Efficacy of majun e khabsul hadeed in iron deficiency anemia in reproductive age group: A randomised control study

Background and Objectives: Iron deficiency is a condition in which blood lacks adequate healthy red blood cells. Women of child bearing age are at high risk. In India incidence is 74% and prevalence is 30%. The goals of treatment are to restore changes in hemoglobin levels, red cell indices and peripheral smear. Aim of the study is to evaluate the effect of majune khabsul hadeed in iron deficiency anemia in women of reproductive age group. Methods: A randomised standard controlled study, 60 patients were randomly allocated to test and control groups. Majune khabsul hadeed 5grams in test group and capsule fefol 1 in control group were given once daily for 3months. Subjective parameters viz. pallor, loss of appetite, reduced exercise capacity and fatigue were assessed at every follow up. Red cell indices, as objective parameters were assessed before and after treatment. Results: Significant changes were observed in subjective parameters with p&lt;0.001 at each assessment in both groups. On intergroup comparison there were no significant difference with p&gt;0.05 except for reduced exercise capacity and fatigue. Objective parameters significantly improved in both groups after treatment with p&lt;0.001. Five (16.7%) and 4(13.3%) patients were among responders, 10(33.3%) and 14(46.7%) partial responders and 13(43.3%) and 12(36.7%) non responders to treatment in test and control groups respectively. On intergroup comparison, there was no significant difference with p &gt;0.05 suggesting that both groups had similar effect. Conclusion: Majune khabsul hadeed is as effective as capsule fefol in the management of iron deficiency anemia in women of reproductive age group. Keywords: Iron deficiency anemia; majune khabsul hadeed; women of reproductive age; RBC indices.

Comparative evaluation of different oral iron salts in the management of iron deficiency anemia.

Anemia affects one-fourth of the world's population and is caused mostly by iron deficiency. Iron supplementation is the most essential strategy for preventing iron deficiency anemia. Conventional oral iron salts have many drawbacks such as poor absorption & bioavailability, and poor tolerability resulting in poor clinical outcomes. To compare the effectiveness and safety of ferrous ascorbate, ferrous fumarate, ferrous bis-glycinate, and Sucrosomial iron in the management of iron deficiency anemia. The study is a retrospective observational clinical study comprising 260 subjects with hemoglobin between 7-10g/dl. The patients were divided into four groups I, II, III, and IV, and received ferrous fumarate, ferrous ascorbate, ferrous bis-glycinate, and Sucrosomial iron respectively. Hematological profile and iron store indices were measured at baseline and month 3. One-way ANOVA followed by Tukey multiple comparison test was used to assess statistical significance (P < 0.05) using GraphPad Prism V.9.3.1 software. The observational study showed that hemoglobin levels were significantly increased in the ferrous ascorbate group (11.86 ± 0.09; P < 0.0001), ferrous fumarate group (11.72 ± 0.08; P < 0.0001), ferrous bis-glycinate group (11.69 ± 0.11; P = 0.0003) and Sucrosomial iron group (12.20 ± 0.1; P < 0.0001) compared to the baseline. The Sucrosomial iron-supplemented group showed significantly higher improvement in hemoglobin levels and serum ferritin levels compared to conventional oral iron salts (P < 0.05) with a better safety profile. The Sucrosomial iron showed significantly higher improvement in hemoglobin levels and higher improvement in iron store indices parameters along with a good tolerability profile compared to other conventional oral iron salts.

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.

A meta-analysis of ferric carboxymaltose versus other intravenous iron preparations for the management of iron deficiency anemia during pregnancy.

We conducted a meta-analysis of randomized clinical trials evaluating the clinical effects of ferric carboxymaltose therapy compared to other intravenous iron in improving hemoglobin and serum ferritin in pregnant women. We also assessed the safety of ferric carboxymaltose vs. other intravenous iron. EMBASE, PubMed, and Web of Science were searched for trials related to ferric carboxymaltose in pregnant women, published between 2005 and 2021. We also reviewed articles from google scholar. The keywords "ferric carboxymaltose," "FCM," "intravenous," "randomized," "pregnancy," "quality of life," and "neonatal outcomes" were used to search the literature. The search was limited to pregnant women. Studies related to ferric carboxymaltose in pregnancy were scanned. Observational studies, review articles, and case reports were excluded. Randomized studies in pregnant women involving ferric carboxymaltose and other intravenous iron formulations were shortlisted. Of 256 studies, nine randomized control trials were selected. Two reviewers independently extracted data from nine selected trials. The final effect size for increase in hemoglobin after treatment was significant for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 0.89g/dl [95% confidence interval 0.27,1.51]). The final effect size for the increase in ferritin after treatment was more for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 22.53µg/L [-7.26, 52.33]). No serious adverse events were reported with ferric carboxymaltose or other intravenous iron. Ferric carboxymaltose demonstrated better efficacy than other intravenous iron in increasing hemoglobin and ferritin levels in treating iron deficiency anemia in pregnant women.

Inpatient management of iron deficiency anemia in pediatric patients with inflammatory bowel disease: A single center experience.

Screening for iron deficiency anemia (IDA) is important in managing pediatric patients with inflammatory bowel disease (IBD). Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous (IV) iron to treat IDA in this population. To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our center. A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019. 92 patients met study criteria for IDA, of which 57 received IV iron, 17 received oral iron, and 18 were discharged prior to receiving iron therapy. Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9 (± 0.2) g/dL in mean (± SE) hemoglobin (Hb) concentration by the first ambulatory follow-up, compared to patients who received oral iron 0.8 (± 0.3) g/dL or no iron 0.8 (± 0.3) g/dL (P = 0.03). One out of 57 (1.8%) patients that received IV iron therapy experienced an adverse reaction. Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.

Comparative evaluation of anti-anemic effect of Sucrosomial iron in experimental model of iron deficiency anemia in Wistar rats

Abstract Anemia is a grave public health issue that affects 25% of the global population. Conventional iron formulations used in treatment have drawbacks such as poor bioavailability and gastric intolerability. The current study aimed to evaluate the anti-anemic effects of different iron salts in Wistar rats with iron deficiency anemia (IDA). IDA was induced by the validated pre-clinical model by retro-orbital bloodletting (1 ml) for 21 days along with an iron-deficient diet in Wistar rats. The rats (n=48) were assigned into 8 groups: Control group, IDA rats, IDA rats receiving either vehicle or different iron salts (ferrous sulfate, ferrous ascorbate, ferrous fumarate, and Sucrosomial iron) for 21 days at a dose of 30 mg/kg p.o. Hematological parameters and iron store indices were assessed at each visit. Anemia induction markedly reduced hemoglobin levels in all IDA groups on day 21. In contrast, iron supplements showed significant improvement in hematological profile after 21 days of treatment. Interestingly, the Sucrosomial iron-supplemented group (group 8) showed significantly higher improvement in hemoglobin levels and hematocrit than did conventional iron supplements such as ferrous sulfate (group 5), ferrous ascorbate (group 6) and ferrous fumarate (group 7) (p &lt;0.05 for each group, respectively). Sucrosomial iron also showed slightly better improvement in iron store indices (serum iron &amp; ferritin levels, total iron binding capacity and transferrin saturation [%]) when compared with other iron supplements (non-significant difference). Authors concluded that Sucrosomial iron has a significant potential to improve IDA in Wistar rats compared to conventional iron salts. Sucrosomial iron can be useful for the management of IDA either prophylactically or therapeutically.

Describing and Comparing Patient Factors Associated with Use of Parenteral Iron before and after Implementation of an Order Set for Parenteral Iron (DECODE IRON).

In select clinical scenarios, IV administration of iron is suitable for management of iron deficiency anemia; however, for most patients, oral administration of iron is the mainstay of treatment. At the Red Deer Regional Hospital Centre, in Red Deer, Alberta, high utilization of IV iron has resulted in limited access to this medication for the treatment of ambulatory patients, as well as significant usage of health care resources. The primary objective was to compare patient characteristics, specifically pretreatment laboratory test results and previous use of oral iron, among those receiving IV iron therapy in an ambulatory setting before and after implementation of an iron sucrose order set. For secondary objectives, the aforementioned groups were compared with regard to meeting the diagnostic criteria for iron deficiency anemia, with or without pretreatment oral iron or blood transfusion, and the dosing characteristics for IV iron. A retrospective electronic chart review was performed for ambulatory patients who received IV iron between January 1, 2020, and January 31, 2022. A total of 436 unique treatment courses were included in the analysis. The following pretreatment laboratory results were observed before and after implementation of the iron sucrose order set: mean hemoglobin 105.8 (standard deviation [SD] 21.9) g/L versus 102.2 (SD 18.5) g/L; mean of mean corpuscular volume (MCV) 82.2 (SD 9.4) fL versus 79.2 (SD 8.9) fL; and median ferritin 7 (interquartile range [IQR] 4-12) μg/L versus 6 (IQR 4-11) μg/L. Only the difference in MCV values was statistically significant (p = 0.001). The implementation of an iron sucrose order set for ambulatory patients did not have a significant effect on pretreatment laboratory parameters among patients for whom IV iron was prescribed. Further stewardship initiatives could be beneficial in improving the appropriateness of IV iron use.