Randomized clinical trial to evaluate ferric carboxymaltose and iron sucrose for treatment of postpartum anaemia in a tertiary hospital

Background: Ferric carboxymaltose and iron sucrose are two iron carbohydrate complexes optimized for iron delivery and extensively used in postpartum anaemia. This study compares the efficacy and safety of ferric carboxymaltose with that of iron sucrose in patients with postpartum anaemia.Methods: One hundred women diagnosed with postpartum anaemia were randomized prospectively in a 1:1 ratio to receive either ferric carboxymaltose or iron sucrose. Fifty patients received intravenous iron carboxymaltose depending on the iron deficit at rate of 1000 mg/week and fifty patients received intravenous iron sucrose at a rate of 200 mg/day on alternate days till the calculated dose is given.Results: Fifty patients were enrolled in each treatment group. Both groups showed increases in mean haemoglobin from baseline at 2 weeks and 6 weeks. The increase in haemoglobin was significantly higher in ferric carboxymaltose group compared to iron sucrose at both week 2 (2.64±0.91 versus 2.17±0.76; p=0.010) and week 6 timepoints (4.65±1.17 versus 3.96±1.06; p=0.005). The proportion of patients achieving target haemoglobin of 12 gm/dl was significantly higher in ferric carboxymaltose group compared to iron sucrose at week 6 (77.3% versus 50.0%; p=0.013). The incidence of adverse events was similar across treatment groups and no specific safety concerns were observed.Conclusions: Both ferric carboxymaltose and iron sucrose caused increase in baseline haemoglobin. Ferric carboxymaltose had significantly higher increases in haemoglobin compared to iron sucrose at both follow up timepoints (week 2 and week 6). It was more likely to achieve target haemoglobin with ferric carboxymaltose within 6 weeks compared to iron sucrose. Ferric carboxymaltose may be considered in women with postpartum anaemia for faster rise in haemoglobin while requiring fewer injections compared to iron sucrose.

Study of efficacy of intravenous iron sucrose therapy in iron deficiency anaemia of pregnancy

Background: Anaemia is the most common medical disorder in pregnancy and is responsible for higher of the maternal deaths in the developing countries. Objective: To determine the efficacy of intravenous iron sucrose, in anemic pregnant women, presenting at Mamata General Hospital, Khammam. Methods: Fifty patients with proved iron deficiency anemia having haemoglobin between 8-10gm% were included in the study. Total iron deficit was calculated by standard formula. Target haemoglobin to be achieved was 11gm%. Iron sucrose was administered by intravenous infusion in divided doses. Haemoglobin was repeated 3 weeks after the last dose of intravenous iron sucrose. Gestational Age, Socio economic class distribution was calculated in percentage , Pre and post treatment Hb% was calculated by mean and standard deviation and P-value was Assessed. Results: Majority of the patients i.e. 60% had gestational age between 32-34 weeks, 30% were in between 29-31 weeks of gestational age while 10% were between 26-28 weeks gestation. The Mean gestational age was 32.4±2.7. Distribution of cases by socio economic status showed, 40% belonged to lower class, 32% belonged to middle class and 28% were from upper class. Intravenous iron sucrose therapy was effective in 90% of the patients without any side effects. There were no allergic reactions. Conclusion: This study showed a significant improvement in the haemoglobin of the patients who received iron sucrose infusion. Patients achieved the target of 11 gram % haemoglobin. It was safe and well tolerated. Health Renaissance, January-April 2013; Vol. 11 No.1; 107-110 DOI: http://dx.doi.org/10.3126/hren.v11i2.8216