scholarly journals A comparative study of ferric carboxymaltose and iron sucrose as a parenteral iron treatment in iron deficiency anaemia during pregnancy

Author(s):  
Alpesh R. Patel ◽  
Vipul S. Patel ◽  
Parth R. Patel

Background: Iron deficiency anemia during pregnancy is a serious global concern specially in developing country, which is preventable with effective measures. In women who cannot tolerate oral iron or have moderate to severe anemia, parenteral iron in the form of iron sucrose or ferric carboxymaltose can be very much useful. This study aimed to compare efficacy and safety of iron sucrose and ferric carboxymaltose in iron deficiency anemia during pregnancy.Methods: This prospective interventional comparative study was conducted during May 2016 to April 2018 at tertiary care hospital and total 100 antenatal women from 28 to 34 weeks of gestation having moderate to severe anemia were included in this study and all women were divided in to 2 groups randomly and were given either iron sucrose or ferric carboxymaltose according to iron requirement. Rise in haemoglobin and serum ferritin were noted and data analysed statistically.Results: The mean rise of haemoglobin with iron sucrose was 1.8 gm% and with ferric carboxymaltose was 2.6 gm%. The mean rise of serum ferritin with iron sucrose was 82.4 ng/ml and with ferric carboxymaltose was 100.9 ng/ml. Other than minimal local reaction one woman had developed severe anaphylactic reaction after receiving iron sucrose.Conclusions: Intravenous ferric carboxymaltose is better and safe molecule than iron sucrose and it has advantage of ability to administer large dose in single sitting which reduce overall cost of therapy.  Hence ferric carboxymaltose is a drug of choice as parenteral iron therapy in iron deficiency anemia during second trimester of pregnancy. 

Author(s):  
Kirtan Krishna ◽  
Achint Krishna ◽  
Divya Teja G. N.

Background: Postpartum iron deficiency anemia is common in India as a consequence of postpartum hemorrhage.  Recent studies have evaluated the use of parenteral iron as a better tolerated treatment modality. Compared with oral iron supplements, parenteral iron is associated with a rapid rise in serum ferritin and hemoglobin and improved maternal fatigue scores in the postpartum period.  Parenteral iron may be considered for the treatment of postpartum anemia. The objective of the study was to evaluate the efficacy, safety, and tolerability of intravenous ferric carboxymaltose, in women with postpartum anemia.Methods: A clinical observational study was undertaken in a tertiary care hospital,  50 women within six weeks of delivery with Hb ≥6 gm/dl and ≤10 gm/dl received 1000 mg/week,  over 15 minutes or less, repeated weekly to a calculated replacement dose (maximum 2500 mg) . Hemoglobin and serum ferritin levels were recorded prior to treatment and on day 21 after completion of treatment.Results: Ferric carboxymaltose-treated subjects achieved a hemoglobin greater than 12 gm/dL in a short time period (21 days), achieve a hemoglobin rise of ≥3 gm/dL more quickly, and attain higher serum ferritin levels. It is also associated with better patient compliance, and shorter treatment period. Drug-related adverse events occurred less frequently with ferric carboxymaltose. The only noted disadvantage was that it is more expensive when compared to other iron preperations.Conclusions: Intravenous ferric carboxymaltose was safe and well tolerated with good efficacy and better patient compliance in the treatment of postpartum iron deficiency anemia.


2016 ◽  
Vol 22 (3) ◽  
pp. 125
Author(s):  
Sertac Esin ◽  
Bülent Yırcı ◽  
Tuğba Zengin ◽  
Serdar Yalvaç ◽  
Ömer Kandemir

<p><strong>Objective:</strong> Parenteral iron therapy for iron deficiency anemia is gaining popularity due to its fast and impressing action. However, effectiveness and safety of iron sucrose in pregnant patient population is less clear. In this study, we aimed to review our intravenous iron sucrose use in pregnant patients.</p><p><strong>Study Design:</strong> The medical records of all anemic pregnant patients hospitalized for parenteral iron sucrose therapy were reviewed retrospectively.</p><p><strong>Results:</strong> The results of 117 pregnant women were available. Thirty-one (26.5%) and 86 (73.5%) of the patients were in the 2<sup>nd</sup> and 3<sup>rd</sup> trimester of the pregnancy, respectively. Four (%3.4) of the patients had severe and 113 (%96.6) of the patients had moderate anemia. The median gestational age for iron sucrose administration was 31.1 weeks (26.8-34.3). The mean hemoglobin, hematocrit and ferritin levels before and after delivery were 10.8±1.3 gr/l; 9.9±1.3 gr/l, 33.5±4.0; 30.8±4.0 and 89.6±0.7 μg/L; 98.1±0.9 μg/L, respectively. All but 2 (1.8%) patients had elevated hemoglobin levels after iron sucrose therapy. When hemoglobin and hematocrit levels were compared between before iron sucrose therapy and before delivery, there was a 2.8 g/l and 7.8 % increase in the mean hemoglobin and hematocrit levels, respectively and the difference was statistically significant (<em>p</em>= 0.001 and <em>p</em>=0.001, respectively). Five patients (4.3%) reported mild hypersensitivity reaction to intravenous iron in the form of mild itching at the infusion site. No severe or life-threatening hypersensitivity reaction was reported.</p><strong>Conclusion:</strong> In this study, we found out that intravenous iron sucrose therapy for iron deficiency anemia is feasible, effective and has a good safety profile.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Marisa Roldão ◽  
Rachele Escoli ◽  
Hernâni Gonçalves ◽  
Karina Lopes

Abstract Background and Aims Iron deficiency anemia occurs in the vast majority of patients with chronic kidney disease (CKD). The aim of this study was to investigate the efficacy of ferric carboxymaltose (FCM) iron deficiency anemia’s treatment in non-dialysis CKD patients and to clarify its impact on kidney function. Method Prospective observational study of non-dialysis CKD stage 3 to 5 patients, with anemia and iron deficiency treated with FCM from 01 January 2019 to 31 June 2020. FCM was administrated as a single IV infusion of 500mg or 1000mg. Baseline clinical, analytical and demographic data were recorded. FCM efficacy was evaluated by comparing hemoglobin (Hb), serum ferritin and transferrin saturation index (TSAT) 24 ± 8 weeks after the infusion with analytical values at baseline. Renal function was also assessed at baseline and at 24 ± 8 weeks using estimated glomerular filtration rate (eGFR), calculated by CKD-EPI formula. Statistical analysis was executed using SPSS (Version 23 for Mac OSX). Results The average age of 71 patients was 77.31 ± 9.68 years, 29 (40.8%) were male, 46 (64.8%) were diabetic and 41 (57.8%) had congestive heart failure. Sixteen (22.5%) patients had CKD stage 3, 41 (57.7%) stage 4 and 14 (19.7%) stage 5. Twenty-five (35.2%) patients were treated with 1000mg of FCM. At baseline, average hemoglobin level (Hb) was 10.16 ± 1.12g/dL, serum ferritin 83.25 ± 96.55µg/L, TSAT 14.48 ± 6.72mg/dL and eGFR 24.21± 13.09ml/min/1.73m2. At 24 ± 8 weeks, Hb showed an increase of 1.31 ± 1.49 g/dL (p=0.001) and TSAT 10.68 ± 10.40% (p=0.001). Serum ferritin showed also an increase of 4.75 ± 180.53µg/L but did not reach statistical significance. The increase in Hb was observed uniformly across all stages of CKD. A Pearson correlation revealed a positive correlation between the variation of Hb and eGFR during the study follow-up period (r=0.310, p=0.008). A subgroup analysis was performed, patients were classified in 2 groups according to FCM dose. At baseline, there was no age, comorbidities or eGFR difference among groups. Patients treated with 1000mg had lower Hb (p=0.03) and serum ferritin (p=0.01). At 24±8 weeks both groups showed increases in Hb (p=0.001) and TSAT (p=0.001). Patients treated with 1000mg showed also a significant increase in ferritin (p=0.004). The Pearson correlation confirmed a positive correlation between the variation of Hb and eGFR in the group of patients treated with 1000mg (r=0.467, p=0.019) but not in the group treated with 500mg. Conclusion FCM was effective in the treatment of iron deficiency anemia in non-dialysis CKD stage 3 to 5 patients. In our population, the increase of Hb levels correlated with an improvement in eGFR in patients treated with higher doses of FCM, suggesting a positive impact of FCM on kidney function.


Author(s):  
Mohamed Saber ◽  
Mohamed Khalaf ◽  
Ahmed M. Abbas ◽  
Sayed A. Abdullah

Anemia is a condition in which either the number of circulating red blood cells or their hemoglobin concentration is decreased. As a result, there is decreased transport of oxygen from the lungs to peripheral tissues. The standard approach to treatment of postpartum iron deficiency anemia is oral iron supplementation, with blood transfusion reserved for more server or symptomatic cases. There are a number of hazards of allogenic blood transfusion including transfusion of the wrong blood, infection, anaphylaxis and lung injury, any of which will be devastating for a young mother. These hazards, together with the national shortage of blood products, mean that transfusion should be viewed as a last resort in otherwise young and healthy women. Currently, there are many iron preparations available containing different types of iron salts, including ferrous sulfate, ferrous fumarate, ferrous ascorbate but common adverse drug reactions found with these preparations are mainly gastrointestinal intolerance like nausea, vomiting, constipation, diarrhoea, abdominal pain, while ferrous bis-glycinate (fully reacted chelated amino acid form of iron) rarely make complication. Two types of intravenous (IV) preparations available are IV iron sucrose and IV ferric carboxymaltose. IV iron sucrose is safe, effective and economical. Reported incidence of adverse reactions with IV iron sucrose is less as compared to older iron preparations (Iron dextran, iron sorbitol), but it requires multiple doses and prolonged infusion time. Intramuscular iron sucrose complex is particularly contraindicated because of poor absorption. It was also stated that when iron dextran is given intravenously up to 30% of patients suffer from adverse effects which include arthritis, fever, urticaria and anaphylaxis.


Author(s):  
Divyani Agrawal ◽  
Deepa Lokwani Masand

Background: Anemia is one of the common manageable problem among the pregnant women worldwide, which contributes to maternal and perinatal mortality. This study aims to compare the efficacy and safety of intravenous ferric carboxymaltose with intravenous iron sucrose in treating anemia during pregnancy. Objective of this study was to compare safety and efficacy of intravenous ferric carboxymaltose with intravenous ferric sucrose in iron deficiency anemia during pregnancy.Methods: It’s an interventional prospective study conducted in Department of Obstetrics and Gynecology at NIMS, Jaipur, Rajasthan, India constituting of 100 pregnant women. Group 1- 50 pregnant women were treated with intravenous ferric carboxymaltose and Group 2: 50 pregnant women were treated with intravenous iron sucrose. Hemoglobin and serum ferritin levels were measured pre and post treatment with parenteral iron therapy. The efficacy of intravenous ferric carboxymaltose in comparison to intravenous iron sucrose was assessed. The evaluation of safety and tolerance with the parenteral therapy was also performed.Results: Anemia during pregnancy was more prevalent among the reproductive age group and in multiparous women. The mean rise in the hemoglobin level with ferric carboxymaltose was 2.92 gm/dl and with that of iron, sucrose was 1.08 gm/dl. The man rise in the serum ferritin levels with ferric carboxymaltose was 64.97ng/ml and with iron sucrose was 31.64 ng/ml. Ferric carboxymaltose was observed to be safer with no adverse events in comparison to the Iron sucrose which was related with adverse events among 03 pregnant women.Conclusions: Intravenous ferric carboxymaltose was more efficacious and safer in comparison to intravenous iron sucrose among pregnant women. Hence, ferric carboxymaltose is the drug of choice in treatment of iron deficiency anemia during pregnancy.


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