scholarly journals Comparative study of efficacy and safety of parenteral iron sucrose versus ferric carboxymaltose in treatment of postpartum iron deficiency anaemia

Author(s):  
Ganesh N. Dakhle ◽  
Mrunalini V. Kalikar ◽  
Rujuta P. Fuke ◽  
Anisha S. Parmarthi ◽  
Mrunalini K. Chokhandre

Background: Postpartum anaemia often leads to multiple clinical complications in mother as well as infant and iron supplementation with parenteral iron is the preferred treatment modality. The present study was planned to compare the efficacy and tolerability of IV iron sucrose and IV ferric carboxymaltose in treatment of postpartum iron deficiency anaemia.Methods: This randomized, parallel, open label, prospective 4-weeks study was conducted from June 2019 to December 2020 in women with postpartum anaemia admitted to obstetrics and gynaecology inpatient department of a tertiary care hospital. Women with postpartum iron deficiency anaemia (N=60) were randomly divided into two groups; receiving Injection iron sucrose (N=30, maximum dose 500 mg) or Injection ferric carboxymaltose (N=30, maximum dose 500 mg). Change in haemoglobin and serum ferritin levels from baseline to the end of 2 and 4 weeks of treatment were evaluated.Results: The results showed early, sustained and significant increase in the haemoglobin levels in both the groups. However, the difference was not significant between groups (p=0.2). Evaluation of replenishment of iron stores (serum ferritin) showed improvement in both the groups, however in FCM group the rise was found to be significant (p<0.05).Conclusions: FCM in a lower dose of 500mg was found to be safe and effective in significantly improving haemoglobin concentration as well as in replenishing iron stores in patients with postpartum anaemia.

2020 ◽  
Vol 4 (02) ◽  
pp. 39-43
Author(s):  
Huque Mahfuz ◽  
Mohammad Elias Hossain ◽  
Mohammed Mosleh Uddin ◽  
Mostafil Karim

Background: Iron deficiency anaemia (IDA) is a common haematological complication with potentially serious clinical consequences that may require intravenous iron therapy. Parenteral iron therapy results faster and higher replenishment of iron stores and correction of Haemoglobin (Hb) levels with better compliance. The study was to compare the efficacy of intravenous ferric carboxymaltose with intravenous iron sucrose to treat iron deficiency anaemia. Methods: 188 patients were included in the study. 100 patients were given iron sucrose. After a 25 mg test dose on the first infusion only, this was given at a dose of 300 mg by intravenous infusion diluted in 100 ml of normal saline, every alternate day. 88 patients were treated with ferric carboxymaltose at a dose of 500 mg diluted in 100 ml of normal saline by intravenous infusion. Hb level and serum Ferritin of both groups were done before iron therapy and 3 weeks after iron therapy. Results: The mean±SD rise of haemoglobin concentration 3 weeks after iron therapy in iron sucrose group was 11.0±0.61 g/dL, while in ferric carboxymaltose group was 11.2±0.64 g/dL. The mean±SD ferritin 3 weeks after iron therapy in iron sucrose group was 76.0±14.28 ng/mL, while in ferric carboxymaltose group was 80.0±15.16 ng/mL. No serious adverse events were reported in either the ferric carboxymaltose group or iron sucrose group. Conclusions: Ferric carboxymaltose causes higher rise in Hb level as compared to parenteral iron sucrose.


2021 ◽  
Vol 8 (22) ◽  
pp. 1803-1807
Author(s):  
Anish Kumar Vishal ◽  
Dinesh Bhasin ◽  
Vidhu Dhar Dangwal ◽  
Anurakshat Bhasin

BACKGROUND Anaemia is one of the major public health problems in developing nations. Iron deficiency anaemia (IDA) is the commonest type of anaemia in pregnancy. Parenteral iron therapy is a recommended modality of treatment of IDA. Inj. Ferric Carboxymaltose (FCM) is a dextran free preparation which is safe, easy to deliver and better tolerated. A maximum of 1000 mg can be infused at a time. The present study was intended to assess the efficacy and safety of Inj. FCM in the treatment of iron deficiency anaemia in the second and third trimester. METHODS This prospective study was conducted at a tertiary care centre at Pune. Pregnant women with iron deficiency anaemia of moderate and severe grade were infused 1000 mg of Inj. FCM by longer infusion protocol. A total of 165 pregnant women were included in the study. The efficacy of Inj. FCM was monitored by the rise in the haemoglobin level at 03-, 06- and 08-weeks post infusion of FCM injection and serum Ferritin levels. The safety was assessed by analysing the adverse reactions. RESULTS No serious adverse reaction was recorded in any of the patients. The rise in haemoglobin (Hb) in second and third trimester of moderate and severe grade of anaemia was significant (P < 0.001). The target level of 10 g / dl was achieved in every patient. Only 03 patients received blood transfusion and that was for obstetric indications. No blood transfusion was because of anaemia per se. The rise in serum ferritin level was also statistically significant (P < 0.001). CONCLUSIONS Inj. FCM is an excellent modality to treat iron deficiency anaemia in pregnancy. It is safe and the rise of haemoglobin with correction of anaemia is satisfactory in a short span of time. In our country where only a handful of patients had regular antenatal check-up and non-compliancy and refractory anaemia is rampant, Inj. FCM is a big boon. KEYWORDS Iron Deficiency Anaemia, Inj. Ferric Carboxymaltose, Serum Ferritin, Blood Transfusion


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.


2019 ◽  
Vol 7 (1) ◽  
pp. 132
Author(s):  
Gaurav Mohan ◽  
Gurinder Mohan ◽  
Manish Chandey ◽  
Avneet Kaur ◽  
Trimaan Singh Sikand ◽  
...  

Background: To study the prevalence and pattern of iron deficiency (ID)in heart failure (HF) patients with or without anaemia.Methods: This is a single-centre observational study, conducted at a tertiary care hospital of Punjab. Patients were selected based on validated clinical criteria-Framingham criteria. The iron parameters were done during the study including serum iron, serum ferritin, total iron binding capacity, and transferrin saturation (TSAT), to diagnose iron deficiency anaemia. Anaemia was defined as haemoglobin (Hb) < 13g/dl in males and <12 g/dL in females, based on WHO definition. Absolute iron deficiency is defined as serum ferritin < 100 mg/L and functional ID was defined as normal serum ferritin (100–300 mg/L) with low TSAT (<20%).Results: A total of 120 patients of Heart Failure (54% males and 46% females) were studied. Most of the patients were of high-functional NYHA class (Class IV NYHA n=45). Iron Deficiency was present in 60% patients with 31.66% patients having absolute and 28.33% patients having functional ID. Nearly one-fifth of the patients were having ID but without anemia, signifying importance of workup of Iron deficiency other than haemoglobin levels.Conclusions: Study highlights the neglected burden of ID in HF patients in India. This study suggests further large-scale studies to better characterize this easily treatable condition and considering routine testing in future Indian guidelines.


Author(s):  
Soniya Vishwakarma ◽  
Rajani Rawat ◽  
Pragati Dwivedi ◽  
Vaibhav Kanti

Background: Iron deficiency anaemia is one of the major morbidities during post-partum period. The aim of this study was to compare the efficacy, safety and compliance of intravenous iron sucrose complex with oral Iron therapy in treatment of postpartum anemia.Methods: 100 postpartum anaemic patients randomized into two groups. In Group I oral iron ferrous sulphate tablets twice daily and in group II 200 mg of iron sucrose on every alternate day up to total calculated dose for 6 weeks. Hemoglobin and serum ferritin were measured on day 0, 2 week and 6 weeks. The side effects in both groups were noted.Results: Majority of patients are multiparous, illiterate and belonged to low socioeconomic. Mean baseline hemoglobin in oral group (Group I) was 7.90±0.905 gm /dl and in i/v group (Group II) was 7.81±0.849 gm /dl. There was significant rise in hemoglobin and hematocrit in both groups after 2 weeks and 6 weeks. However, efficiency of iron sucrose was greater in between the groups (p value=0.0000). There was a rise in serum ferritin to 58.35±14.537μg/L from 8.30±1,461μg/L after 6 weeks in intravenous group with shorter duration of treatment indicating a high efficacy (p<0.001). Intravenous iron sucrose did not result in any serious adverse reactions.Conclusions: This study illustrates clearly that intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with oral ferrous sulphate.


Author(s):  
LAYANA V. S ◽  
RANI MANJU ◽  
MATHEW GEORGE ◽  
LINCY JOSEPH

Deficiency of iron is one of the most common nutritional disorders in the society. Iron deficiency anemia is described as decreased production in red blood cells (RBCs) due to low body iron stores.Anemia commonly occurs in people with chronic kidney disease and it might begin to develop in the early stages and tends to worsen as disease progresses. Iron supplementation is mandatory in the majority of patients with renal disease, particularly in those receiving ESA therapy. Treatment with intravenous iron in some clinical situations could present some advantages over oral iron, such as faster and higher increases of hemoglobin (Hb) levels and body iron stores. Some modern formulations of intravenous iron have emerged as a safe and effective alternative for iron deficiency anaemia management. E.g.: iron sucrose. Ferric carboxy maltose is a parenteral iron dextran-free product and the first of the new agents approved for rapid and high-dose replenishment of depleted iron stores. Keywords:  Iron deficiency anaemia, chronic kidney disease, hemoglobin, iron sucrose, ferric carboxy maltose


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