What are the effects of oral or parenteral iron supplementation to reduce deferral, iron deficiency, and/or anemia in blood donors?

2019 ◽  
Author(s):  
Jane Burch ◽  
Sera Tort
Keyword(s):  
Iron Deficiency ◽  
Iron Supplementation ◽  
Blood Donors ◽  
Parenteral Iron

scholarly journals A randomized, blinded, placebo-controlled trial of education and iron supplementation for mitigation of iron deficiency in regular blood donors

Transfusion ◽  
2016 ◽  
Vol 56 (6pt2) ◽  
pp. 1588-1597 ◽  
Author(s):  
Alan E. Mast ◽  
Walter Bialkowski ◽  
Barbara J. Bryant ◽  
David J. Wright ◽  
Rebecca Birch ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Supplementation ◽  
Blood Donors ◽  
Controlled Trial

scholarly journals Ferric Gluconate Complex in Elderly Hospital Inpatients without Terminal Kidney Failure

2018 ◽  
Vol 71 (3) ◽  
Author(s):  
Patrick Viet-Quoc Nguyen ◽  
Judith Latour
Keyword(s):  
Iron Deficiency ◽  
Elderly Patients ◽  
Iron Deficiency Anemia ◽  
Kidney Failure ◽  
Iron Supplementation ◽  
Adverse Reactions ◽  
Deficiency Anemia ◽  
Patients Âgés ◽  
Parenteral Iron ◽  
Taux D’Hémoglobine

<p><strong>ABSTRACT</strong></p><p><strong>Background: </strong>Anemia is a common health issue for elderly patients. For patients with iron deficiency who cannot tolerate iron supplementation by the oral route, the parenteral route may be used. Options for parenteral iron supplementation include ferric gluconate complex (FGC).</p><p><strong>Objectives: </strong>To evaluate the safety of FGC in elderly patients without terminal kidney failure and to assess its efficacy in treating iron-deficiency anemia.</p><p><strong>Methods: </strong>An observational chart review was conducted at a tertiary care university health centre. Patients included in the study were 65 years of age or older, had received at least 1 dose of FGC between January 1, 2014, and December 31, 2015, and had a hemoglobin count of less than 130 g/L (men) or less than 120 g/L (women) at baseline. For each patient, the observation period began when the first dose of FGC was administered and ended 60 days after the last dose. The main safety outcome (occurrence of any adverse reaction) was evaluated for every patient, with the efficacy analysis being limited to patients with a diagnosis of iron deficiency anemia.</p><p><strong>Results: </strong>A total of 144 patients were included in the study, of whom 76 had iron-deficiency anemia. No serious, life-threatening adverse reactions were reported. The most commonly reported adverse reactions were nausea and vomiting. The mean increase in hemoglobin count was 13.5 g/L, a statistically significant change from baseline.</p><p><strong>Conclusions: </strong>These results show that FGC is safe for use in elderly patients, with very few mild adverse reactions. Use of FGC led to increased hemoglobin count within 60 days. Of the 3 options for parenteral iron supplementation available in Canada, iron sucrose has not been studied in elderly patients, and iron dextran has a higher incidence of anaphylaxis, whereas FGC appears to be a safe alternative for patients with intolerance to oral iron.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte : </strong>L’anémie est un problème de santé courant chez les patients âgés. Les patients qui présentent une carence en fer et une intolérance à la prise de suppléments de fer par la voie orale peuvent être traités par voie parentérale. Le complexe de gluconate ferrique de sodium (CGFS) représente l’une des options d’apport complémentaire en fer par voie parentérale.</p><p><strong>Objectifs : </strong>Évaluer l’innocuité du CGFS chez le patient âgé qui n’est pas atteint d’insuffisance rénale terminale et évaluer son efficacité dans le traitement de l’anémie ferriprive.</p><p><strong>Méthodes : </strong>Une analyse observationnelle a été menée au moyen des dossiers médicaux dans un établissement de santé universitaire de soins tertiaires. Les patients dont le dossier médical a été retenu pour l’analyse étaient âgés de 65 ans ou plus, avaient reçu au moins une dose de CGFS entre le 1er janvier 2014 et le 31 décembre 2015 et présentaient initialement un taux d’hémoglobine de moins de 130 g/L (hommes) ou de moins de 120 g/L (femmes). Pour chaque patient, la période d’observation s’étendait du moment où la première dose de CGFS avait été administrée au soixantième jour suivant la dernière dose. Le principal paramètre d’évaluation de l’innocuité (survenue de toute reaction indésirable) faisait l’objet d’une évaluation pour chaque patient. L’analyse de l’efficacité se limitait aux patients ayant reçu un diagnostic d’anémie ferriprive.</p><p><strong>Résultats : </strong>Au total, 144 patients ont été admis à l’étude et, parmi eux, 76 présentaient une anémie ferriprive. Aucune réaction indésirable grave menaçant la vie du patient n’a été notée. Les réactions indésirables les plus souvent signalées étaient des nausées et des vomissements. L’augmentation moyenne des taux d’hémoglobine était de 13,5 g/L, un changement statistiquement significatif comparé à la valeur de départ.</p><p><strong>Conclusions : </strong>Les résultats montrent que le CGFS est sécuritaire pour le patient âgé et qu’il ne provoque que très peu de réactions indésirables légères. L’emploi du CGFS a produit une augmentation des taux d’hémoglobine en moins de 60 jours. Parmi les 3 options d’apport complémentaire en fer pris par voie parentérale disponibles au Canada, le fer-saccharose n’a pas été étudié auprès de patients âgés et le fer-dextran est associé à une plus grande incidence de cas d’anaphylaxie; or, le CGFS semble être une solution sécuritaire pour les patients qui présentent une intolérance au fer administré par voie orale.</p>

Parenteral iron supplementation for the treatment of iron deficiency anemia in children

2002 ◽  
Vol 81 (3) ◽  
pp. 154-157 ◽  
Author(s):  
G. Surico ◽  
P. Muggeo ◽  
V. Muggeo ◽  
A. Lucarelli ◽  
T. Martucci ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
Deficiency Anemia ◽  
Parenteral Iron

Analysis Of TMPRSS6 Polymorphisms In Patients With Iron Deficiency Anemia Partially Responsive To Oral Iron Treatment

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3438-3438 ◽  
Author(s):  
Erika Poggiali ◽  
Fabio Andreozzi ◽  
Isabella Nava ◽  
Paola Delbini ◽  
Lorena Duca ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
Rare Variants ◽  
Hematological Parameters ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Healthy Donors ◽  
New Variant ◽  
Parenteral Iron

Abstract Introduction Iron Refractory Iron Deficiency Anemia (IRIDA) is an autosomal recessive form of iron deficiency anemia (IDA) caused by mutations in TMPRSS6 gene, and characterized by unresponsiveness to oral iron supplementation and low effectiveness of parenteral iron administration (Finberg 2009). So far 50 cases from 32 families have been reported and 40 mutations have been identified (De Falco 2013). Although mutations are extremely rare, recent insights have revealed that highly frequent polymorphisms of TMPRSS6 gene may influence iron absorption, being associated with increased risk of IDA (An 2012). Patients and Methods Between January 2009 and May 2013, 88 subjects (11 males, 77 females) with mean age 39+/-14 years were referred to the Hereditary Anemia Centre of “Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano” for persistent IDA poorly responsive to oral iron. All the patients (pts) were investigated for celiac disease, gastrointestinal bleeding, and HP infection. Hematological parameters, iron status, inflammatory markers, and thyroid function were tested. Sequence variation in TMPRSS6 gene was evaluated by PCR and direct sequencing in genomic DNA isolated from peripheral lymphocytes. Thalassemia trait was suspected and investigated in 27/88 (31%) pts (3 males, 24 females) using HPLC and genetic analysis of globin chains. Fifty healthy donors (15 females, 35 males) with mean age 28±9 yrs were used as control group. Results Frequency of SNP-120, SNP-113, P33P, K253E, Y418Y, D521D, Δ15accc and V739Y results significantly different between pts and controls. Association study revealed that in pts homozygosis for V736A is frequently associated with homozygosis for D521D and Y739Y, while polymorphic alleles F5F, P33P, K253E, S361S, Δ15accc are linked to V736A trans-allele. Based on the observation that homozygosis for V736A is not present in healthy control, we analyzed the hematological parameters in anemic pts homozygotes, heterozygotes, and wild type for V736A. No significant differences were found (table 1). Considering only the thalassemia pts, the combination of thalassemia trait and V736A is associated with a more severe anemia (Hb 10.3±1.4 g/dL, MCV 62.9±6.7 fL median ferritin 30 ng/mL), requiring blood transfusion in particular circumstances (pregnancy, surgery). Moreover, one new variant (H448R) was identified in a pt with IDA requiring parenteral iron supplementation. Two rare variants, A719T and V795I (estimated frequency 0.000/1 and 0.004/9), were detected respectively in two sisters, causing the IRIDA phenotype only in one, and in two patients, who require parenteral iron therapy. Discussion and Conclusion Several TMPRSS6 polymorphisms are more frequent in anemic pts than in healthy donors, suggesting their role in the refractoriness to oral iron. No significant differences were observed in hematological data related to V736A genotype. This is not surprising because all the pts were previously treated with iron therapy, which contribute to partially reduce the degree of anemia. In this study we found peculiar haplotypes, a new variant (H448R) and two rare variants (A719T and V795I), which may account for impairment in TMPRSS6 activity. Further studies are necessary to clarify the role of TMPRSS6 polymorphysms, which will allow identifying individuals at risk for more severe IDA, particularly in thalassemia pts, driving to correct diagnosis and management of iron supplementation, sparing to the patient inadequate therapeutic choices and diagnostic procedures. Disclosures: Cappellini: NOVARTIS: Membership on an entity’s Board of Directors or advisory committees.

scholarly journals Established and Emerging Concepts to Treat Imbalances of Iron Homeostasis in Inflammatory Diseases

2018 ◽  
Vol 11 (4) ◽  
pp. 135 ◽  
Author(s):  
Verena Petzer ◽  
Igor Theurl ◽  
Günter Weiss
Keyword(s):  
Iron Deficiency ◽  
Iron Supplementation ◽  
Iron Homeostasis ◽  
Inflammatory Diseases ◽  
Clinical Investigation ◽  
Underlying Disease ◽  
Mononuclear Phagocyte ◽  
Diagnostic Approaches ◽  
Iron Retention ◽  
Parenteral Iron

Inflammation, being a hallmark of many chronic diseases, including cancer, inflammatory bowel disease, rheumatoid arthritis, and chronic kidney disease, negatively affects iron homeostasis, leading to iron retention in macrophages of the mononuclear phagocyte system. Functional iron deficiency is the consequence, leading to anemia of inflammation (AI). Iron deficiency, regardless of anemia, has a detrimental impact on quality of life so that treatment is warranted. Therapeutic strategies include (1) resolution of the underlying disease, (2) iron supplementation, and (3) iron redistribution strategies. Deeper insights into the pathophysiology of AI has led to the development of new therapeutics targeting inflammatory cytokines and the introduction of new iron formulations. Moreover, the discovery that the hormone, hepcidin, plays a key regulatory role in AI has stimulated the development of several therapeutic approaches targeting the function of this peptide. Hence, inflammation-driven hepcidin elevation causes iron retention in cells and tissues. Besides pathophysiological concepts and diagnostic approaches for AI, this review discusses current guidelines for iron replacement therapies with special emphasis on benefits, limitations, and unresolved questions concerning oral versus parenteral iron supplementation in chronic inflammatory diseases. Furthermore, the review explores how therapies aiming at curing the disease underlying AI can also affect anemia and discusses emerging hepcidin antagonizing drugs, which are currently under preclinical or clinical investigation.

scholarly journals The Effect of Parenteral or Oral Iron Supplementation on Fatigue, Sleep, Quality of Life and Restless Legs Syndrome in Iron-Deficient Blood Donors: A Secondary Analysis of the IronWoMan RCT

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1313
Author(s):  
Susanne Macher ◽  
Cornelia Herster ◽  
Magdalena Holter ◽  
Martina Moritz ◽  
Eva Maria Matzhold ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Restless Legs Syndrome ◽  
Iron Supplementation ◽  
Blood Donors ◽  
Secondary Analysis ◽  
Chronic Fatigue ◽  
Oral Iron ◽  
Restless Legs ◽  
Fatigue Syndrome ◽  
Iron Deficient

Background: Besides anemia, iron deficiency may cause more subtle symptoms, including the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis of the IronWoMan randomized controlled trial (RCT) was to compare the frequency and severity of symptoms associated with iron deficiency before and after (intravenous or oral) iron supplementation in iron deficient blood donors. Methods/Design: Prospective, randomized, controlled, single-centre trial. (ClinicalTrials.gov: NCT01787526). Setting: Tertiary care center in Graz, Austria. Participants: 176 (138 female and 38 male) whole-blood and platelet apheresis donors aged ≥ 18 and ≤ 65 years with iron deficiency (ferritin ≤ 30ng/mL at the time of blood donation). Interventions: Intravenous iron (1 g ferric carboxymaltose, n = 86) or oral iron supplementation (10 g iron fumarate, 100 capsules, n = 90). Measurements: Clinical symptoms were evaluated by a survey before iron therapy (visit 0, V0) and after 8–12 weeks (visit 1, V1), including questions about symptoms of restless legs syndrome (RLS), chronic fatigue syndrome (CFS), sleeping disorders, quality of life and symptoms like headaches, dyspnoea, dizziness, palpitations, pica and trophic changes in fingernails or hair. Results: We found a significant improvement in the severity of symptoms for RLS, fatigue and sleep quality (p < 0.001). Furthermore, a significant decrease in headaches, dyspnoea, dizziness and palpitations was reported (p < 0.05). There was no difference between the type of iron supplementation (intravenous versus oral) and clinical outcome data. Conclusion: Iron supplementation in iron-deficient blood donors may be an effective strategy to improve symptoms related to iron deficiency and the wellbeing of blood donors.

scholarly journals The Effect of Parenteral or Oral Iron Supplementation on Fatigue, Sleep, Quality of Life and Restless Legs Syndrome in Iron Deficient Blood Donors: A Secondary Analysis of the Ironwoman Rct

2020 ◽  
Author(s):  
Susanne Macher ◽  
Cornelia Herster ◽  
Magdalena Holter ◽  
Martina Moritz ◽  
Eva Maria Matzhold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Iron Deficiency ◽  
Sleep Quality ◽  
Iron Supplementation ◽  
Blood Donors ◽  
Secondary Analysis ◽  
Oral Iron ◽  
Sleeping Disorders ◽  
Iron Deficient

Background: Besides anemia, iron deficiency may cause more subtle symptoms including those of the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis was to compare the frequency and severity of symptoms associated with iron deficiency before and after (intravenous or oral) iron supplementation in iron deficient blood donors. Methods/Design: Prospective, randomized, controlled, single centre trial. (ClinicalTrials.gov: NCT01787526). Setting: Tertiary care center in Graz, Austria Participants: 138 female and 38 male whole blood and platelet apheresis donors aged &ge;18 and &le;65 years with iron deficiency (ferritin &le;30ng/ml at the time of blood donation). Interventions: Intravenous iron (1 g ferric carboxymaltose, n=86) or oral iron supplementation (10 g iron fumarate, 100 capsules, n=90). Measurements: Clinical symptoms were evaluated by a survey before iron therapy (visit 0, V0) and after 8-12 weeks (visit 1, V1) including questions about symptoms of RLS, CFS, sleeping disorders, quality of life and symptoms like headaches, dyspnoea, dizziness, palpitations, pica and trophic changes of fingernails or hair. Results: We found a significant improvement in the severity of symptoms for RLS, fatigue and sleep quality (p&lt;0.001). Furthermore, a significant decrease of headaches, dyspnoea, dizziness and palpitations was reported (p&lt;0.05). There was no difference between the type of iron supplementation (intravenous versus oral) and clinical outcome data. Conclusion: Iron supplementation in iron deficient blood donors may be an effective strategy to improve symptoms related to iron deficiency and the wellbeing of blood donors.

Screening with zinc protoporphyrin for iron deficiency in non-anemic female blood donors

1990 ◽  
Vol 36 (6) ◽  
pp. 846-848 ◽  
Author(s):  
B M Jensen ◽  
S H Sandø ◽  
P Grandjean ◽  
P Wiggers ◽  
J Dalhøj
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Supplementation ◽  
Blood Donors ◽  
Age Groups ◽  
Zinc Protoporphyrin ◽  
Blood Hemoglobin ◽  
Increased Risk ◽  
Donation Frequency ◽  
Average Serum

Abstract Iron-depleted donors are at increased risk of developing anemia; if these donors could be identified by a screening test, iron supplementation or decreased donation frequency could be considered. Tests to determine serum ferritin, blood hemoglobin, and erythrocyte (Erc)-zinc protoporphyrin concentrations were examined in 679 consecutive female blood donors to identify donors with non-anemic iron deficiency. The test to determine serum ferritin is expensive and slow, whereas the two latter tests are rapid and less costly and could therefore be used for screening. Women in the fertile age groups had the lowest average serum ferritin values. In all, 93 women (13.7%) had depleted iron stores, as indicated by serum ferritin concentrations less than 14 micrograms/L. In these women, a much better correlation was found between Erc-zinc protoporphyrin and serum ferritin (rs = -0.49, P less than 0.001) than between blood hemoglobin and serum ferritin (rs = 0.31, P less than 0.01). These findings suggest that measurement of Erc-zinc protoporphyrin is superior to that of blood hemoglobin in identifying donors with non-anemic iron deficiency.

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