scholarly journals Single Dose Preoperative Administration of Intravenous Iron Corrects Iron Deficiency Anaemia in Colorectal Cancer

2010 ◽  
Vol 01 (01) ◽  
Author(s):  
J A D Simpson S L Ng
Keyword(s):  
Colorectal Cancer ◽  
Single Dose ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Intravenous Iron ◽  
Deficiency Anaemia ◽  
Preoperative Administration

scholarly journals Intravenous iron is non-inferior to oral iron regarding cell growth and iron metabolism in colorectal cancer associated with iron-deficiency anaemia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hafid O. Al-Hassi ◽  
Oliver Ng ◽  
Rayko Evstatiev ◽  
Manel Mangalika ◽  
Natalie Worton ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Iron Deficiency ◽  
Iron Metabolism ◽  
Iron Deficiency Anaemia ◽  
Iron Transport ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Loading ◽  
Deficiency Anaemia ◽  
Iron Treatment

AbstractOral iron promotes intestinal tumourigenesis in animal models. In humans, expression of iron transport proteins are altered in colorectal cancer. This study examined whether the route of iron therapy alters iron transport and tumour growth. Colorectal adenocarcinoma patients with pre-operative iron deficiency anaemia received oral ferrous sulphate (n = 15), or intravenous ferric carboxymaltose (n = 15). Paired (normal and tumour tissues) samples were compared for expression of iron loading, iron transporters, proliferation, apoptosis and Wnt signalling using immunohistochemistry and RT-PCR. Iron loading was increased in tumour and distributed to the stroma in intravenous treatment and to the epithelium in oral treatment. Protein and mRNA expression of proliferation and iron transporters were increased in tumours compared to normal tissues but there were no significant differences between the treatment groups. However, intravenous iron treatment reduced ferritin mRNA levels in tumours and replenished body iron stores. Iron distribution to non-epithelial cells in intravenous iron suggests that iron is less bioavailable to tumour cells. Therefore, intravenous iron may be a better option in the treatment of colorectal cancer patients with iron deficiency anaemia due to its efficiency in replenishing iron levels while its effect on proliferation and iron metabolism is similar to that of oral iron treatment.

scholarly journals RAPIDIRON: Reducing Anaemia in Pregnancy in India A 3-Arm, Randomized-Controlled Trial Comparing The Effectiveness of Oral Iron With Single-Dose Intravenous Iron In The Treatment of Iron Deficiency Anaemia In Pregnant Women And Reducing Low Birth Weight Deliveries.

2021 ◽  
Author(s):  
Richard Derman ◽  
Shivaprasad Goudar ◽  
Simal Thind ◽  
Sudhir Bhandari ◽  
Zubair Aghai ◽  
...  
Keyword(s):  
Single Dose ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Controlled Trial ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Reproductive Age ◽  
Deficiency Anaemia ◽  
Randomized Controlled ◽  
In Pregnancy

Abstract Background: Anaemia is a worldwide problem and iron deficiency is the most common cause. In pregnancy, anaemia increases the risk of adverse maternal, foetal and neonatal outcomes.India’s anaemia rate is among the highest in the world with India’s National Family Health Survey indicating over 50% of pregnant women were affected by anaemia. India’s Anaemia Mukt Bharat-Intensified National Iron Plus Initiative aims to reduce the prevalence of anaemia among reproductive-age women, adolescents and children by 3% per year and facilitate the achievement of a Global World Health Assembly 2025 objective to achieve a 50% reduction of anaemia among women of reproductive age. However, preliminary results of the NFHS-5 survey completed in 2020 indicate that anaemia rates are increasing in some states and these targets are unlikely to be achieved. With oral iron being the first-line treatment for iron deficiency anaemia (IDA) in pregnancy, these results are likely to be impacted by the side effects, poor adherence to tablet ingestion and low therapeutic impact of oral iron. These reports suggest a new approach to treating IDA, specifically the importance of single-dose intravenous iron infusions, may be the key to India effectively reaching its targets for anaemia reduction. Methods: This 3-arm, randomized controlled trial is powered to report two primary outcomes. The first is to assess whether a single dose of two different intravenous formulations administered early in the second trimester of pregnancy to women with moderate IDA will result in a higher percentage of participants achieving a normal for pregnancy Hb concentration at 30-34 weeks’ gestation or just prior to delivery when compared to participants taking standard doses of oral iron. The second is a clinical outcome of low birth weight (LBW) (< 2500 grams), with a hypothesis that the risk of LBW delivery will be lower in the intravenous iron arms when compared to the oral iron arm. Discussion: The RAPIDIRON trial will provide evidence to determine if a single-dose intravenous iron infusion is more effective and economically feasible in reducing IDA in pregnancy than the current standard of care.Trial registration: Clinical Trials Registry – India: CTRI/2020/09/027730. Registered 10 September 2020, http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=46801&EncHid=&userName=anemia%20in%20pregnancy

scholarly journals RAPIDIRON: Reducing Anaemia in Pregnancy in India—a 3-arm, randomized-controlled trial comparing the effectiveness of oral iron with single-dose intravenous iron in the treatment of iron deficiency anaemia in pregnant women and reducing low birth weight deliveries

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Richard J. Derman ◽  
Shivaprasad S. Goudar ◽  
Simal Thind ◽  
Sudhir Bhandari ◽  
Zubair Aghai ◽  
...  
Keyword(s):  
Single Dose ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Controlled Trial ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Reproductive Age ◽  
Deficiency Anaemia ◽  
Randomized Controlled ◽  
In Pregnancy

Abstract Background Anaemia is a worldwide problem and iron deficiency is the most common cause. In pregnancy, anaemia increases the risk of adverse maternal, foetal and neonatal outcomes. India’s anaemia rate is among the highest in the world with India’s National Family Health Survey indicating over 50% of pregnant women were affected by anaemia. India’s Anaemia Mukt Bharat-Intensified National Iron Plus Initiative aims to reduce the prevalence of anaemia among reproductive-age women, adolescents and children by 3% per year and facilitate the achievement of a Global World Health Assembly 2025 objective to achieve a 50% reduction of anaemia among women of reproductive age. However, preliminary results of the NFHS-5 survey completed in 2020 indicate that anaemia rates are increasing in some states and these targets are unlikely to be achieved. With oral iron being the first-line treatment for iron deficiency anaemia (IDA) in pregnancy, these results are likely to be impacted by the side effects, poor adherence to tablet ingestion and low therapeutic impact of oral iron. These reports suggest a new approach to treating IDA, specifically the importance of single-dose intravenous iron infusions, may be the key to India effectively reaching its targets for anaemia reduction. Methods This 3-arm, randomized controlled trial is powered to report two primary outcomes. The first is to assess whether a single dose of two different intravenous formulations administered early in the second trimester of pregnancy to women with moderate IDA will result in a higher percentage of participants achieving a normal for pregnancy Hb concentration at 30–34 weeks’ gestation or just prior to delivery when compared to participants taking standard doses of oral iron. The second is a clinical outcome of low birth weight (LBW) (< 2500 g), with a hypothesis that the risk of LBW delivery will be lower in the intravenous iron arms when compared to the oral iron arm. Discussion The RAPIDIRON trial will provide evidence to determine if a single-dose intravenous iron infusion is more effective and economically feasible in reducing IDA in pregnancy than the current standard of care. Trial registration Clinical Trials Registry – India CTRI/2020/09/027730. Registered on 10 September 2020, http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=46801&EncHid=&userName=anemia%20in%20pregnancy

scholarly journals Study of outcome of the treatment with intravenous iron sucrose in moderately anaemic pregnant women

2019 ◽  
Vol 8 (9) ◽  
pp. 3480
Author(s):  
Kohila Kalimuthu ◽  
Vanusha Avudaithangam
Keyword(s):  
Standard Deviation ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anaemia ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
P Value ◽  
Deficiency Anaemia ◽  
The Mean ◽  
The Difference

Background: Moderate anaemia seen in about 15-20% of pregnant women. Iron sucrose complex which is used intravenously for the correction of Iron deficiency anaemia. The drug has been able to raise the haemoglobin to satisfactory level when used in moderately anaemic iron deficient pregnant women. The objective of this study was to study the improvement of Hb% after treatment with intravenous Iron sucrose complex in moderately anaemic pregnant women belonging to 24-32 weeks of gestational age.Methods: 50 antenatal patients between gestational age 24-32 weeks with hemoglobin between 8-9.5g/dl were selected and included in this study. They were subjected to blood hemoglobin estimation, hematocrit and peripheral smear study. In each infusion, the maximum total dose administered was 200 mg iron sucrose in 100 ml of normal saline, slow IV infused over 30 minutes. Monitoring was done throughout the infusion to observe for any side effects.Results: Mean hemoglobin among the 50 patients before starting the therapy was 8.172g/dl and the mean hemoglobin at the end of one month of completing the therapy was 11.066g/dl. The rise in mean hemoglobin i.e. the difference in the mean hemoglobin before and after treatment was 2.894g/dl. The p value is 0.0001 which is statistically significant. The mean hematocrit of the 50 patients studied before starting the treatment was 26.772% with a standard deviation of 1.914. The mean hematocrit after completing the therapy was 33.872% with a standard deviation of 1.321. The difference in the mean hematocrit was 7.100% with a p value of 0.0001 which is statistically significant.Conclusions: Intravenous iron sucrose complex is well tolerated and highly efficacious in improving hemoglobin, hematocrit in the treatment of iron deficiency anaemia in antenatal women.

scholarly journals Intravenous versus oral iron therapy in treatment of postpartum anaemia

2017 ◽  
Vol 6 (8) ◽  
pp. 3454
Author(s):  
Neelima Agarwal ◽  
Preeti Sharma
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Ferrous Sulphate ◽  
Intravenous Iron ◽  
Hemoglobin Level ◽  
Oral Iron ◽  
Chi Square ◽  
Deficiency Anaemia ◽  
Significant Difference ◽  
Red Cell Indices

Background: Postpartum iron deficiency anaemia (IDA) is common in women. Most women are treated with either oral iron supplementation or blood transfusion. Hence, the aim of our study was to compare the effect of treatment with either oral ferrous sulphate or intravenous ferrous sucrose on postpartum IDA.Methods: 100 postpartum women with proven iron deficiency anaemia with hemoglobin <9gm/dl and serum ferritin <15 µgm/l were included in the study. They were randomized to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group 1) or intravenous ferrous sucrose 200 mg, two to three doses given on alternate days (group 2). Total iron deficit was calculated using a standard formula. Target hemoglobin was 11 gm/dl. Results were analysed by the students t-test and chi-square test. Hemoglobin, hematocrit, red cell indices and ferritin were measured on day 2-3, 1-2 weeks and 6 weeks postpartumResults: By 1-2 weeks, hemoglobin level in women treated with intravenous iron had risen from 7.81±0.849 to 9.88±0.760 gm/dl which was more than those treated with oral iron (p<0.01); although by 6 weeks, there was no significant difference between the two groups. Ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (p<0.01).Conclusions: Intravenous iron sucrose increases the hemoglobin level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly. 

scholarly journals NIMO-CKD-UK: a real-world, observational study of iron isomaltoside in patients with iron deficiency anaemia and chronic kidney disease

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Philip A. Kalra ◽  
Sunil Bhandari ◽  
Michael Spyridon ◽  
Rachel Davison ◽  
Sarah Lawman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Observational Study ◽  
Adverse Drug Reactions ◽  
Real World ◽  
Iron Deficiency Anaemia ◽  
Intravenous Iron ◽  
Drug Reactions ◽  
Deficiency Anaemia

Abstract Background Intravenous iron is often used to treat iron deficiency anaemia in non-dialysis chronic kidney disease (ND-CKD), but the optimal dosing regimen remains unclear. We evaluated the impact of high- versus low-dose intravenous iron isomaltoside on the probability of retreatment with intravenous iron in iron-deficient ND-CKD patients. Methods This real-world, prospective, observational study collected data from 256 ND-CKD patients treated for anaemia in the UK. Following an initial course of iron isomaltoside, patients were followed for ≥12 months. Iron dose and the need for retreatment were determined at the investigators’ discretion. The primary study outcome was the need for retreatment at 52 weeks compared between patients who received >1000 mg of iron during Course 1 and those who received ≤1000 mg. Safety was evaluated through adverse drug reactions. Results The probability of retreatment at Week 52 was significantly lower in the >1000 mg iron group (n = 58) versus the ≤1000 mg group (n = 198); hazard ratio (95% confidence interval [CI]): 0.46 (0.20, 0.91); p = 0.012. Mean (95% CI) haemoglobin increased by 6.58 (4.94, 8.21) g/L in the ≤1000 mg group and by 10.59 (7.52, 13.66) g/L in the >1000 mg group (p = 0.024). Changes in other blood and iron parameters were not significantly different between the two groups. Administering >1000 mg of iron isomaltoside saved 8.6 appointments per 100 patients compared to ≤1000 mg. No serious adverse drug reactions were reported. Of the patients who received ≤1000 mg of iron in this study, 82.3% were eligible for a dose >1000 mg. Conclusions The >1000 mg iron isomaltoside regimen reduced the probability of retreatment, achieved a greater haemoglobin response irrespective of erythropoiesis-stimulating agent treatment, and reduced the total number of appointments required, compared to the ≤1000 mg regimen. Many of the patients who received ≤1000 mg of iron were eligible for >1000 mg, indicating that there was considerable underdosing in this study. Trial registration ClinicalTrials.gov NCT02546154, 10 September 2015.

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