scholarly journals Hematological responses to oral administration of iron polymoltose complex in anemic and normal pregnant women: A comparative study

1970 ◽  
Vol 6 (3) ◽  
pp. 1-7
Author(s):  
P Sunitha ◽  
N Satyanarayana ◽  
MM Shaik ◽  
S Mobina ◽  
KB Lakshmi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Blood Parameters ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Medical Sciences ◽  
Oral Iron Therapy ◽  
Medical Disorder ◽  
Before And After ◽  
Prevalence Of Anemia

Anemia is a common medical disorder affecting a lot of women in pregnancy in the developing countries. Daily oral iron supplementation during pregnancy reduces the prevalence of anemia. In the present study we have compared the hematological responses to oral iron therapy using the formulation of iron poly maltose complex in anemic and normal pregnant women. The haemoglobin (Hb) level and other blood parameters were studied in anemic and non-anemic pregnant women both before and after oral iron therapy. Hemoglobin, iron indicators improved significantly with oral iron therapy and appear to have good compliance and efficacy. This helps us to assess the varied comparative responses in both the categories. The study will be indicative about the rational use of iron in iron deficiency anemia. Key words: Anemia; blood; hemoglobin; deficiency. DOI: 10.3126/jcmsn.v6i3.4067Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.1-7

scholarly journals A Comparative Study between Lactoferrin versus ferrous sulfate in iron-deficiency during pregnancy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
T F Borg ◽  
K M Labib ◽  
G M Darwish
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Ferrous Sulfate ◽  
Ferrous Sulphate ◽  
Maternity Hospital ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Once Daily ◽  
Oral Iron Therapy

Abstract Background Iron deficiency anemia (IDA) is the condition in which there is decrease in the number of red blood cells or the amount of hemoglobin in the blood. It is caused by insufficient dietary intake and absorption of iron, or iron loss from bleeding. Bleeding can be from a range of sources such as the intestinal, uterine or urinary tract. Aim of the Work to compare the efficacy and the safety of lactoferrin versus ferrous sulphate for the treatment of iron deficiency pregnant women. Patients and Methods This randomized clinical trial was conducted on 98 women selected from pregnant women attending the antenatal outpatient clinic of Ain Shams University Maternity hospital. All patients were divided into two groups; the first group included 49 pregnant women who received lactoferrin (Pravotin100 mg sachets, Hygint pharmaceuticals, Egypt) twice daily orally for 30 days which was dissolved in 1/4 glass of water before meals by 15 minutes. The second group included 49 pregnant women who received 520 mg of dried ferrous sulphate tablets (Feosol tablets, Meda pharmaceuticals, Egypt) once daily orally for 30 days on empty stomach but may be taken with meals to avoid stomach upset. Results Total increase in HB after 1month with lactoferrin was higher compared to ferrous sulfate (-13.572 gdl)(p < 0.001). Gastroinestinal adverse events occurred more frequently with ferrous sulfate than the lactoferrin group (p < 0.001).The number of women requesting change the drug was higher in the ferrous sulfate group(p < 0.001). Conclusion Oral lactoferrin was better tolerated and more acceptable with higher increase in mean hemoglobin when compared to oral iron therapy over one month treatment. Oral lactoferrin can be used as a good substitute to oral iron therapy in iron deficiency during pregnancy.

scholarly journals IRON ABSORPTION AND RESPONSE TO ORAL IRON THERAPY IN IRON DEFICIENCY ANEMIA ASSOCIATED TO ASYMPTOMATIC GIARDIASIS.

1993 ◽  
Vol 33 (6) ◽  
pp. 661-661
Author(s):  
Helena U Suzuki ◽  
Mauro B Morais ◽  
Jose N Corral ◽  
Ulisses Fagundes-Neto ◽  
Nelson L Machado
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Oral Iron Therapy

scholarly journals Comparative Study of the Effects of Lactoferrin versus Oral Iron Therapy in Obese Children and Adolescents with Iron Deficiency Anemia

2021 ◽  
pp. 104-114
Author(s):  
Manal Mahmoud Atia ◽  
Rasha Mohamed Gama ◽  
Mohamed Attia Saad ◽  
Mohammed Amr Hamam
Keyword(s):  
Iron Deficiency ◽  
Children And Adolescents ◽  
Iron Deficiency Anemia ◽  
Interleukin 6 ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Obese Children ◽  
Oral Iron Therapy ◽  
Serum Hepcidin

Greater prevalence of iron deficiency (ID) has been observed in overweight and obese children and adolescents. Hepcidin acts as a key regulator of iron metabolism. Hepcidin synthesis increases in response inflammatory cytokines especially Interleukin-6 (IL-6). Considering that obesity represents a low grade chronic inflammatory state, a high concentration of hepcidin has been found in obese children. Elevated hepcidin level in obese children is associated with diminished response to oral iron therapy. Lactoferrin is an iron-binding multifunctional glycoprotein and has strong capacity to modulate the inflammatory response by its capacity to reduce pro-inflammatory cytokine expression in vivo, including IL-6 and hepcidin. Aim of the Work: To compare the efficacy of lactoferrin versus oral iron therapy in treatment of obese children and adolescents with iron deficiency anemia and the effect of therapy on serum hepcidin and interleukin 6 levels. Methodology: This prospective randomized clinical trial was conducted on 40 obese children and adolescents aged between 6 –18 years suffering from iron deficiency anemia (IDA). They were equally randomized into one of 2 groups. Group A received regular oral lactoferrin in a dose of 100 mg/day. Group B received regular oral iron supplementation (Ferric hydroxide polymaltose) in a dose of 6 mg elemental iron/kg /day.Baseline investigations included complete blood count (CBC), iron profile (Serum ferritin, serum iron, total iron binding capacity (TIBC), transferrin saturation), serum Interleukin 6, and serum hepcidin. Reevaluation of CBC was done monthly while iron status parameters, serum IL-6 and serum hepcidin were reevaluated after 3 months of receiving regular therapy. Results: Significant elevations in hemoglobin, MCV, MCH, Serum ferritin, serum iron and transferrin saturation with lactoferrin therapy compared to oral iron therapy. Significantly Lower TIBC after 3 months of lactoferrin therapy while the decrease in TIBC was insignificant in the iron therapy group.Lower serum hepcidin and IL6 after 3 months of lactoferrin therapy with no significant change in serum hepcidin and IL6 after iron therapy. Conclusion: This study clearly demonstrated the superiority of lactoferrin over iron use as oral in the treatment of iron deficiency anemia in obese children not only for the better response of hematological and iron status parameters and less gastrointestinal side effects but also for its effect on decreasing inflammatory biomarkers as hepcidin and IL6.

scholarly journals Iron Refractory Iron Deficiency Anemia: Presentation With Hyperferritinemia and Response to Oral Iron Therapy

PEDIATRICS ◽  
2013 ◽  
Vol 131 (2) ◽  
pp. e620-e625 ◽  
Author(s):  
D.-A. Khuong-Quang ◽  
J. Schwartzentruber ◽  
M. Westerman ◽  
P. Lepage ◽  
K. E. Finberg ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Oral Iron Therapy

A Head-to-Head Comparison of the Safety and Efficacy of Ferumoxytol to Iron Sucrose for the Treatment of Iron Deficiency Anemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5157-5157
Author(s):  
Allen Poma ◽  
Karen Diana ◽  
Justin McLaughlin ◽  
Annamaria Kausz
Keyword(s):  
Iron Deficiency ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Safety And Efficacy ◽  
Oral Iron Therapy ◽  
The Us ◽  
Iv Iron ◽  
Iron Replacement

Abstract Abstract 5157 BACKGROUND: Iron replacement therapy is essential for increasing iron stores and raising hemoglobin levels in patients with iron deficiency anemia (IDA). Oral iron supplements have limited absorption and are commonly associated with gastrointestinal (GI) side effects that reduce compliance, resulting in limited increases in hemoglobin. In patients without chronic kidney disease (CKD), oral iron therapy is frequently used to treat IDA. However, when oral iron therapy is unsatisfactory or cannot be tolerated, intravenous (IV) iron therapy may be appropriate. In the US, iron dextrans are the only approved IV iron products indicated for the treatment of IDA in non-CKD patients, and have limitations around convenience because they require a test dose and as many as 10 administrations via a slow infusion; iron dextrans have also been associated with a relatively high rate of serious adverse reactions compared to other IV iron products. Other IV irons, such as iron sucrose and sodium ferric gluconate, are only approved in the US for the treatment of IDA in patients with CKD. Like the iron dextrans, both of these products are limited by administration, requiring 5 to 10 clinic visits for the administration of a full therapeutic dose (1 gram of iron). Feraheme® (ferumoxytol) Injection is an IV iron product approved in the US for the treatment of IDA in adult subjects with CKD. Its carbohydrate coating is designed to minimize immunological sensitivity, and it has less free iron than other IV iron preparations. Ferumoxytol is administered as two IV injections of 510 mg (17 mL) 3 to 8 days apart for a total cumulative dose of 1.02 g. METHODS: To date, there have been a limited number of studies that have examined the safety and efficacy of IV irons in a head-to-head manner for the treatment of IDA, and no study has done so in a large number of subjects or in a broad patient population. AMAG, therefore, has initiated a randomized, controlled trial (ClinicalTrials.gov NCT01114204) to compare ferumoxytol with iron sucrose. Iron sucrose is approved in many countries outside the US for the treatment of IDA in patients intolerant to oral iron therapy, and is considered a safer alternative to IV iron dextran. This open-label trial (n=600) will evaluate the efficacy and safety of a 1.02 g of IV ferumoxytol, administered as 2 doses of 510 mg each, compared with 1.0 g of IV iron sucrose, administered as 5 doses of 200 mg each. Enrolled subjects will have IDA associated with a variety of underlying conditions including abnormal uterine bleeding, GI disorders, cancer, postpartum anemia, and others (eg, nutritional deficiency). Endpoints include changes in hemoglobin and transferrin saturation at Week 5, as well as evaluation of the requirement for erythropoiesis stimulating agent therapy and blood transfusion. Patient reported outcomes instruments will be employed to assess the impact of IV iron therapy on anemia symptoms and health-related quality of life (fatigue, energy, etc). Additionally, detailed information on healthcare utilization will be collected. CONCLUSION In the US, non-CKD patients with IDA who have a history of unsatisfactory oral iron therapy have limited options for iron replacement therapy. Study NCT01114204 will provide novel information comparing the safety and efficacy of two IV iron therapies for the treatment of IDA in a broad patient population. Disclosures: Poma: AMAG Pharmaceuticals, Inc.: Employment. Diana:AMAG Pharmaceuticals, Inc.: Employment. McLaughlin:AMAG Pharmaceuticals, Inc.: Employment. Kausz:AMAG Pharmaceuticals, Inc.: Employment.

scholarly journals Baseline Hepcidin Does Not Predict the Response to Iron Therapy in Pregnant Women with Iron Deficiency

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3076-3076
Author(s):  
Rebecka Hansen ◽  
Joergen Kurtzhals ◽  
Bjarne Styrishave ◽  
Charlotte Holm
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Conflicts Of Interest ◽  
Controlled Trial ◽  
Transferrin Saturation ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Iron Group ◽  
Open Label

Abstract Introduction: Hepcidin, the master regulator of iron economy, is decreased during pregnancy to facilitate adequate iron transfer across the placenta. Conversely, iron need increases substantially during pregnancy often leading to iron deficiency and subsequently anemia. The PREG-01 Study compared the efficacy and safety of intravenous (IV) ferric derisomaltose (FDI) vs. oral iron in treating persistent iron deficiency in pregnant women. The study found FDI to be efficacious and well-tolerated in pregnancy and the proportion of non-anaemic patients throughout the course of the study was significantly lower in the FDI group. In this analysis, we investigated the effect of baseline hepcidin on the response to IV and oral iron therapy. Methods: PREG-01 was a single-centre, open-label, randomized controlled trial. Women 14-21 weeks pregnant with persistent iron deficiency (ferritin<30 µg/L despite oral iron treatment) received a single intravenous 1000 mg dose of FDI (n=100) or 100 mg elemental oral iron daily combined with ascorbic acid (n=101). Hemoglobin (Hb), ferritin and transferrin saturation (TSAT%) levels were captured at baseline and monitored throughout the study. The effect of baseline hepcidin on achieving non-anemic status (Hb ≥ 11 g/dL) at all study visits and the effect on change in Hb, ferritin and TSAT% were investigated by estimating odds ratios from a logistic regression model with treatment as factor and interaction between treatment and baseline hepcidin. The odds ratio estimate is for an increment in baseline hepcidin of 1 ng/mL. Results: Mean [standard deviation (SD)] baseline Hb was 11.97 (0.93) g/dL in the FDI group and 11.75 (0.91) g/dL in the oral iron group. Baseline hepcidin was 6.42 ng/mL in the FDI and 5.32 ng/mL in the oral iron group. Baseline hepcidin was not associated with the ability to achieve non-anaemic status either in the FDI (OR 0.98; 95% CI: 0.87-1.09) or the oral iron group (OR 0.96; 95% CI: 0.88-1.05). No statistically significant associations were found between baseline hepcidin and change in Hb, ferritin or TSAT% throughout the study (Figure 1). Conclusions: In a population of pregnant women with iron deficiency, but otherwise healthy, baseline hepcidin was overall low. Although there was a trend for an association between baseline hepcidin and Hb response to oral iron only, baseline hepcidin did not predict the response to iron therapy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Ferric Derisomaltose is an IV iron preparation indicated for the treatment of iron deficiency anemia in the US.

scholarly journals A RETROSPECTIVE STUDY ON PREVALANCE OF ANEMIA IN PREGNANCY IN A TERITIARY CARE HOSPITAL

2021 ◽  
pp. 106-108
Author(s):  
SYEDA ZAINEB KUBRA HUSSAINI ◽  
BUSHRA SHEREEN ◽  
SIRISHA D ◽  
MADHAVI E ◽  
HARI PRIYA E ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Iron Therapy ◽  
Care Hospital ◽  
Oral Iron Therapy ◽  
Moderate Anemia ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Objective: To study about prevalence in anemia among the antenatal women, its clinical features, and access the severity and its treatment response. Methods: A hospital-based retrospective study on the prevalence of anemia among the antenatal women in tertiary care hospital for 6 months duration in gynecology and obstetrics department. In evaluating pregnant women with anemia, it is essential to do a complete history and physical examination, as well as complete blood count with indices and a blood smear examination. Based on these findings, other test such as ferritin and serum or red cell folate may be ordered. Because of normal physiologic changes in pregnancy that effect the hematocrit, indices, and some other parameters, diagnosing true anemia, as well as the etiology of anemia, is challenging. Results and Discussion: In this retrospective study, the prevalence of Anemia in pregnancy in a tertiary care hospital was evaluated and determined in fifty patients. The most common age group was between 21 and 25 years i.e., (21 patients) 42%. Among 50 patients, majority of them, i.e., 35 patients (70%) were treated with Injection. Iron Sucrose (200 mg). In this study, increase in prevalence were seen majorly in the third trimester, i.e., 25 patients (50%) of which 22 patients (88%) were with moderate anemia with 7.9 gm/dl average hemoglobin (Hb) percentage and 3 patients (12%) were with mild anemia with 9.3 gm/dl average Hb percentage. Conclusion: The plan of management for anemia complicating pregnancy depends on the type of anemia. Oral iron therapy is the route of choice in women with mild to moderate anemia and for severe anemia in pregnant women <30 weeks of gestation. The rise of Hb with parenteral iron therapy is almost the same (avg: 1gm/dl/week) as that of oral iron therapy.

scholarly journals Medication adherence to oral iron therapy in patients with iron deficiency anemia

2016 ◽  
Vol 32 (3) ◽  
Author(s):  
Cigdem Gereklioglu ◽  
Süheyl Asma ◽  
Asli Korur ◽  
Ferit Erdogan ◽  
Altug Kut
Keyword(s):  
Medication Adherence ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Oral Iron Therapy

Intravenous Low Molecular Weight Iron Dextran (LMWID) in the Treatment of Children with Iron Deficiency Anemia,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3184-3184
Author(s):  
Ellen S. Plummer ◽  
Shelley E. Crary ◽  
George R. Buchanan
Keyword(s):  
Molecular Weight ◽  
Single Dose ◽  
Blood Loss ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Iron Dextran ◽  
Oral Iron Therapy ◽  
Iv Iron ◽  
Low Molecular Weight Iron

Abstract 3184 Background: While iron deficiency anemia (IDA) is among the most common hematologic disorders during childhood, management strategies for patients poorly responsive to oral iron therapy have not been well studied. Children treated for IDA often have a poor response to oral iron due to noncompliance, intolerance of side effects, malabsorption, ongoing blood loss, or a combination of these factors. Alternative treatment approaches are therefore needed. Intravenous (IV) iron, including low molecular weight iron dextran (LMWID), offers the possibility of correcting the anemia and repleting iron stores using a single dose, potentially decreasing the overall burden of treatment. Use of LMWID in children has been limited due to concerns about anaphylaxis associated with high molecular weight iron dextran preparations, even though in adults the risk of anaphylaxis is decreased when alternative IV iron preparations, including LMWID, are employed. In this study we report our initial experience with LMWID in children with IDA. Methods: We performed a retrospective record review of patients receiving IV LMWID for IDA in the Center for Cancer and Blood Disorders at Children's Medical Center Dallas between December 1, 2010 and July 31, 2011. Records were reviewed for age, indication for LMWID, concurrent medical problems, use of premedication, initial and follow-up hemoglobin values, adverse events (AEs), and prior or subsequent receipt of other IV iron preparations. The primary study aim was to characterize the clinical course of patients receiving LMWID to inform a planned prospective cohort study of IV iron in children with IDA poorly responsive to oral iron therapy. Results: A total of 18 patients, age 11 months (mos) to 18 years (yrs), received IV LMWID during the study period. 11 of them (median age 13 yrs) received LMWID for IDA secondary to external blood loss due to menorrhagia (n=3), gastrointestinal disease (n=3), hemophilia (n=2), Von Willebrand disease (n=2), and immune thrombocytopenia (n=1). Five (median age 2 yrs) had IDA due to nutritional deficiency, and two patients had multiple causes for their IDA. 14 patients (77.8%) received their initial LMWID infusion without AEs, and all demonstrated an increase in hemoglobin (mean 3 g/dL) 4 to 7 weeks following infusion. Premedication with diphenhydramine, acetaminophen, hydrocortisone, or a combination of these was given to 6 of the 14 patients (42.8%) at the discretion of the treating physician based on history of atopy. The average dose of LMWID was 600 mg (20.2mg/kg) with a range of 150 mg to 1 gram (6.9 mg/kg to 30.9 mg/kg). 3 of these 14 patients (21.4%) required a subsequent infusion to achieve and maintain a normal hemoglobin due to ongoing blood loss. 6 patients (33.3%) had transient AEs during LMWID infusion including hives (n=3), tachycardia (n=2), chest tightness (n=1), fever (n=2), nausea (n=1), vomiting (n=1), sweating (n=2), and cough (n=1). 2 of them were able to complete the infusion without further sequelae after receiving diphenhydramine or hydrocortisone. Only one of the patients with AEs had received premedication, although on review 3 of the 6 patients with AEs had a concurrent medical problem affecting immune function including asthma and orthotopic liver transplant. No patient required hospital admission or treatment of the AE beyond the day of their clinic visit. 4 of the 6 patients with AEs related to LMWID subsequently received IV iron sucrose infusions without any complications. Conclusions: Among 18 children with IDA receiving LMWID planned as a single dose infusion, treatment was well tolerated and effective in 14 of them and associated with only transient AEs in 6. The latter patients were able to either receive the remainder of the LMWID infusion or an alternative iron preparation without complication. Some patients with ongoing blood loss needed additional infusions, although the majority of children were treated effectively with a single dose. These encouraging results support the need for further study of LMWID in children with IDA unresponsive to oral iron therapy or even as an initial treatment alternative to the oral route. Disclosures: No relevant conflicts of interest to declare.

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