Oral Iron Absorption Test (OIAT): A Forgotten Screening Test for Iron Absorption from the Gastrointestinal Tract. A Case Series of 14 Iron Deficiency Anemia (IDA) Patients Treated with FERALGINE®

Background: Celiac disease (CD) is an immunologically-mediated disorder characterized by duodenal mucosa villi atrophy. Iron absorption is usually reduced in celiac patients making every kind of oral iron treatment unhelpful because of malasorption. Feralgine™ is a new product that has been demonstrated to be more bioavailable. As such, the aim of our study was to evaluate the absorption of Feralgine™ in adult patients with CD. Methods: Twenty-six adults affected by Iron Deficiency Anemia (IDA), of which 14 were also affected by CD and 12 were not affected by CD, were enrolled. An oral iron absorption test (OIAT) was performed in each patient by administrating Feralgine™, and serum iron was evaluated at baseline (T0) and after 2 h (T1) from the oral iron ingestion. Results: The OIAT was well tolerated in all patients, and, surprisingly, an equivalent statistically significant improvement in serum iron occurred in the two groups of patients (IDA plus CD: T0 = 28.21 µg/dL vs. T1 = 94.14 µg/dL p = 0.004 and IDA without CD: T0 = 34.91 µg/dL vs. T1 = 118.83 µg/dL, p = 0.0003). Conclusions: These results demonstrated the high absorption of Feralgine™ in celiac patients, confirming our previous data obtained with Ferrous Bysglicinate in children with CD.

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The Cost-effective Usefulness of Oral Iron Absorption Test- Prospective Evaluation in Premenopausal Women with Newly Diagnosed Iron Deficiency Anemia

Annals of Hematology & Oncology ◽

10.26420/annhematoloncol.2018.1201 ◽

2018 ◽

Vol 5 (4) ◽

Author(s):

Islam MS

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Iron Absorption ◽

Premenopausal Women ◽

Cost Effective ◽

Deficiency Anemia ◽

Absorption Test ◽

Newly Diagnosed ◽

Prospective Evaluation ◽

The Cost

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Proton Pump Inhibitor Use and the Ability to Replete Iron Stores

Blood ◽

10.1182/blood.v118.21.1039.1039 ◽

2011 ◽

Vol 118 (21) ◽

pp. 1039-1039

Author(s):

Alina M Huang ◽

Christine M Ho ◽

John L. Reagan ◽

Eric Winer

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Proton Pump ◽

Iron Absorption ◽

Oral Iron ◽

Deficiency Anemia ◽

Care Clinic ◽

Iron Stores ◽

Iron Deficient ◽

Iron Replacement

Abstract Abstract 1039 Background: Oral iron absorption occurs in the duodenum and requires increased gastric acidity to allow iron to remain in the more soluble, ferrous form. Many patients with iron deficiency anemia who require oral iron repletion are on proton pump inhibitors (PPIs) for management of various conditions that require acid suppression for treatment. In vitro studies suggest that inhibition of gastric acid secretion decreases the bioavailability of iron. In patients with established iron deficiency anemia who are on PPIs, there is a paucity of data regarding the efficacy of iron replacement with concomitant PPI use. Sharma et al. published a case report on 2 patients who were iron deficient and on PPI therapy (Sharma et. al. Southern Medical Journal 2004). Their findings showed that discontinuation of the PPI resulted in improvement of iron deficiency anemia on the same dose of oral iron replacement. Additionally, Hutchinson et al. demonstrated that in individuals with hereditary hemachromatosis, those on PPIs had a significant reduction in phlebotomy requirements needed to keep serum ferritin ∼50μg (Hutchinson et. al. Gut 2007). We conducted a retrospective study to assess whether a difference exists in terms of iron repletion between patients on a PPI versus those not on a PPI. Methods: Patients were selected from the medical primary care clinic from charts dating January 2000 until January 2009. Included patients were adults older than 18 years of age, a diagnosis of iron deficiency based on ferritin < 30 with at least one follow up ferritin value, and recipients of oral iron replacement. Excluded patients were those with chronic active bleeding and anemia of chronic disease. Indices examined include iron (Fe), total iron binding capacity (TIBC), ferritin, transferrin saturation, hemoglobin (Hb), hematocrit (Hct), and mean corpuscular volume (MCV). The primary endpoint of interest is repletion of iron stores defined by ferritin > 30. Those who were able to replete their iron stores are termed “responders” and those who were not are termed “nonresponders”. Results: Forty-five patients have been identified who have met the above criteria. Of these patients, 14 were on a PPI and 31 were not on a PPI. Of the patients not on a PPI, 38.7% responded to oral iron. Of the patients on a PPI, 50.0% responded to oral iron. The average initial and final values of indices of interest were compared between the groups (Table 1). Discussion: Our data suggests that patients both on and off PPIs show the ability to replete their iron stores. Furthermore, it appears that a slightly greater percentage of patients on a PPI compared with those not on a PPI are able to replete their iron stores, though the numbers remain small. Most importantly, these findings challenge the commonly held belief that PPI use impairs oral iron absorption. A prospective study is warranted to further confirm these observational data. Disclosures: No relevant conflicts of interest to declare.

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The Oral Iron on the Prevention of Iron Deficiency Anemia in Obese Pregnant

Case Medical Research ◽

10.31525/ct1-nct04101461 ◽

2019 ◽

Author(s):

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Oral Iron ◽

Deficiency Anemia

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Long-term follow-up of patients with iron deficiency anemia after a close endoscopic examination of the upper and lower gastrointestinal tract

Zeitschrift für Gastroenterologie ◽

10.1055/s-2000-9999 ◽

2000 ◽

Vol 38 (10) ◽

pp. 827-832 ◽

Cited By ~ 8

Author(s):

D Schilling ◽

G Grieger ◽

E Weidmann ◽

H E Adamek ◽

C Benz ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Endoscopic Examination ◽

Deficiency Anemia ◽

Lower Gastrointestinal Tract ◽

Long Term Follow Up

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The Treatment of Iron-deficiency Anemia—Palatable but Ineffective Iron Medication

PEDIATRICS ◽

10.1542/peds.31.6.1041 ◽

1963 ◽

Vol 31 (6) ◽

pp. 1041-1044

Author(s):

LOUIS K DIAMOND ◽

J. LAWRENCE NAIMAN ◽

DONALD M. ALLEN ◽

FRANK A. OSKI,

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Ferrous Sulfate ◽

Oral Iron ◽

Gastrointestinal Absorption ◽

Deficiency Anemia ◽

Therapeutic Effects ◽

Rapid Rise ◽

Carbohydrate Complex ◽

Therapeutic Results

Experience with a new oral iron-carbohydrate complex (Jefron) in the treatment of iron-deficiency anemia shows that the therapeutic results are inferior to those obtainable with ferrous sulfate. Many children showed no response after months of treatment with this drug and when subsequently placed on ferrous sulfate therapy showed a rapid rise in hemoglobin to normal levels. Preliminary studies suggest that poor gastrointestinal absorption may be a factor in the inadequate therapeutic effects.

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Intravenous versus Oral iron for Iron-Deficiency Anemia in Pregnancy (IVIDA): A Randomized Controlled Trial

American Journal of Perinatology ◽

10.1055/s-0041-1740003 ◽

2021 ◽

Author(s):

Adam K. Lewkowitz ◽

Molly J. Stout ◽

Emily Cooke ◽

Seon C. Deoni ◽

Viren D'Sa ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Adverse Reactions ◽

Controlled Trial ◽

Oral Iron ◽

Deficiency Anemia ◽

Randomized Controlled ◽

Iv Iron ◽

Severe Adverse Reactions

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points

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Reply: Intravenous Ferumoxytol in Pediatric Patients With Iron-Deficiency Anemia

Annals of Pharmacotherapy ◽

10.1177/1060028017726796 ◽

2017 ◽

Vol 51 (12) ◽

pp. 1146-1146

Author(s):

Nabil E. Hassan

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Pediatric Patients ◽

Iron Absorption ◽

Deficiency Anemia

Iron Deficiency in children is common problem. Its mechanism could be nutritional or due to lack of iron absorption. Several conditions are associated with IDA. Presence of inflammation further complicate attempts to make a definitive diagnoses or accurately quantify reponse to therapy.

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