Intravenous iron sucrose for children with iron deficiency failing to respond to oral iron therapy

2012 ◽  
Vol 58 (4) ◽  
pp. 655-655
Author(s):  
Shelley E. Crary ◽  
Katherine Hall ◽  
George R. Buchanan
Keyword(s):  
Iron Deficiency ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Oral Iron Therapy

scholarly journals Intravenous iron sucrose for children with iron deficiency failing to respond to oral iron therapy

2010 ◽  
Vol 56 (4) ◽  
pp. 615-619 ◽  
Author(s):  
Shelley E. Crary ◽  
Katherine Hall ◽  
George R. Buchanan
Keyword(s):  
Iron Deficiency ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Oral Iron Therapy

scholarly journals Efficacy and safety of high dose accelerated intravenous iron sucrose in patients of iron deficiency anemia

2017 ◽  
Vol 5 (8) ◽  
pp. 3359
Author(s):  
Muzafar Naik ◽  
Tariq Bhat ◽  
Ummer Jalalie ◽  
Arif Bhat ◽  
Mir Waseem ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
High Dose ◽  
Oral Iron Therapy ◽  
The Mean

Background: Low dose (200 mg) extended Intravenous iron sucrose remains the most common treatment option in patients who are intolerant to oral iron therapy in patients with Iron deficiency anemia (IDA). The objective of this study was to evaluate the efficacy and safety of high dose accelerated intravenous iron sucrose (IS) in the treatment of adults with iron deficiency anemiaMethods: One hundred adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received daily doses of 500 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient.Results: The mean and median Hb (g/dL) 6.47±1.656 and 6.6 (2) at baseline, 9.61±1.629 and 9.6 (2) at 2 weeks of treatment, 11.85±1.277 and 12 (1) at 4 weeks of treatment respectively. The mean rise of Hb was 3.13±1.41 and 5.37±1.50 after 2 and 4 weeks of treatment respectively (p<0.000). A total of 303 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with twenty-six patients developing mild and one patient developing moderate adverse drug reactions. There was no serious adverse event recorded.Conclusions: Accelerated high dose intravenous iron sucrose is a safe and cost effective option minimizing frequent hospital visits in the treatment of adults with iron deficiency anemia who are intolerant or lack satisfactory response to oral iron therapy.

Intravenous Iron Sucrose

2017 ◽  
Vol 1 (1) ◽  
pp. 20-22
Author(s):  
KS Kavitha Gautham
Keyword(s):  
Iron Deficiency ◽  
Health Problem ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Current Understanding ◽  
Iron Therapy ◽  
Iron Supplement ◽  
Iv Iron

ABSTRACT Iron deficiency is a major worldwide health problem. There is recent evidence that anemia is the last manifestation of the syndrome. Advances in outlining the physiology of iron deficiency have been made; gaps remain in the current understanding. While oral iron supplement remains the mainstay, some indications for intravenous (IV) administration have developed. In this review, we will highlight the indications and prerequisites of IV iron therapy, dosage, safety, and method of administration. How to cite this article Gautham KSK. Intravenous Iron Sucrose. World J Anemia 2017;1(1):20-22.

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 A comparative study of oral iron and intravenous iron in iron deficient antenatal mothers

2018 ◽  
Vol 7 (5) ◽  
pp. 1848
Author(s):  
Suganya G. ◽  
D. Vimala
Keyword(s):  
Pregnant Women ◽  
Carbonyl Iron ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Oral Iron Therapy ◽  
Iron Deficient ◽  
Group A ◽  
Group B

Background: The aim of the study is to compare the efficacy, tolerance and compliance between oral iron and intravenous infusion of iron in iron deficient antenatal mother.Methods: This is a prospective randomised clinical and interventional study in the department of Obstetrics and Gynaecology in Vinayaka Mission Kirupananda Variyar Medical College and Hospital. The antenatal women attending the antenatal op were screened for Hb status. Those antenatal women of gestational age 16-34 weeks with Hb level between 7-10g% and diagnosed to have iron deficiency anemia by peripheral smear and serum ferritin were included in this study after getting informed consent. The total numbers of 100 mothers were allotted into two major groups, group A and group B of 50 subjects each. Group A: 50 pregnant women given oral iron supplementation (carbonyl iron 100 mg twice a day). Group B: 50 pregnant women given intravenous iron sucrose therapy after calculating the total iron requirement. The rise in hemoglobin in both the groups were comparedResults: In this study the mean rise of hemoglobin in carbonyl iron was 0.914±0.20 gm% whereas in iron sucrose group was 2.43±0.20gm%. This showed that iron sucrose (i.v) had better rise in Hb than carbonyl iron (oral).Conclusions: The present study revealed that intravenous iron sucrose therapy was bettertolerated with higher increase in mean haemoglobin compared to oral iron therapy. There were no serious side effects with intravenous iron sucrose therapy. Intravenous iron sucrose is a good substitute to oral iron therapy in moderate anaemia.

Hepcidin Levels Predict Non-Responsiveness to Oral Iron Therapy in Patients with Iron Deficiency Anemia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 484-484
Author(s):  
Lawrence T. Goodnough ◽  
David Morris ◽  
Todd Koch ◽  
Andy He ◽  
David Bregman
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Predictive Values ◽  
Oral Iron Therapy

Abstract Abstract 484 Background Treatment options for individuals diagnosed with iron deficiency anemia (IDA) include oral or intravenous iron. Oral iron may not increase patient hemoglobin levels adequately, due to poor compliance and/or suboptimal gastrointestinal absorption due to inflammation-mediated induction of hepcidin, which regulates iron homeostasis. This study evaluated whether hepcidin levels can be used to identify patients with IDA who are unresponsive to oral iron therapy. Methods Hepcidin levels were assessed in a subset of subjects enrolled in a randomized trial comparing oral iron (ferrous sulfate) to intravenous iron (Injectafer®[ferric carboxymaltose, FCM]) in subjects with IDA (Hemoglobin [Hb] ≤ 11 g/dL; and ferritin ≤ 100 ng/mL, or ≤ 300 ng/mL when transferrin saturation (TSAT) was ≤ 30%) (Szczech et al Amer Soc Nephrol 2011; 22:405A). Subjects who met the inclusion criteria underwent a 14-day (run-in) course of ferrous sulfate 325 mg, three times per day. Subjects with an increase in Hb ≥ 1 g/dL were considered to be “responders” and not randomized. “Non-responders” were randomized to ferric carboxymaltose (2 injections of 750 mg given on Day 0 [day of randomization] and Day 7) or oral iron for 14 more days. Hb levels and markers of iron status were assessed at screening (day-15), day-1 and day 35. Hepcidin levels were analyzed at screening (Day -15) in an initial Cohort (I) of 44 patients, 22 responders and 22 non-responders. A hepcidin value of >20 ng/mL was identified for further analysis for predictive values for non-responsiveness to 14 day oral iron run-in in 240 patients (Cohort II). Hepcidin levels were also analyzed at Day -1 and Day 35 in a Cohort (III) of patients who were then randomized to FCM vs. oral iron therapy. Results Hepcidin screening levels in Cohort I were significantly higher in the non-responders vs. responders (33.2 vs. 8.7 ng/mL, p < 0.004). Twenty one of 22 non-responders had hepcidin values > 20 ng/mL. For Cohort II, mean hepcidin levels were again significantly higher in the non-responders vs. responders (38.4 vs. 11.3 ng/mL, p = 0.0002). Utilizing a hepcidin criterion of > 20 ng/mL, we found a sensitivity of 41.3% (26 of 150), specificity of 84.4% (76 of 90), and a positive predictive value (PPV) of 81.6% (62 of 76) for non-responsiveness to oral iron (Figure: The Receiver Operator Characteristic curves present plots of sensitivity vs. (1-specificity) for hepcidin, ferritin, and TSAT at the various cutoff levels indicated near the respective curves in the same color as the respective curves). While ferritin < 30ng/mL or TSAT <15% had greater sensitivity (77.3% and 64.7%, respectively), their PPVs (59.2% and 55%) were inferior to PPVs for hepcidin. Patients subsequently randomized to FCM vs. oral iron responded with Hgb increases of ≥1 g/dL for 65.3% vs. 20.8% (p <0.0001)and mean Hgb increases of 1.7 ± 1.3 vs. 0.6 ± 0.9 g/dL (p = 0.0025), respectively. Conclusion Our analysis provides evidence that non-responsiveness to oral iron in patients with iron deficiency anemia can be predicted from patients' baseline hepcidin levels, which have superior positive predictive values compared to transferrin saturation or ferritin levels. Furthermore, non-response to oral iron therapy does not rule out iron deficiency, since two thirds of these non-responders to oral iron responded to IV iron. Disclosures: Goodnough: Luitpold: Consultancy. Off Label Use: ferric carboxymaltose for treatment of iron deficiency anemia. Morris:Luitpold: Consultancy. Koch:Luitpold: Employment. He:Luitpold: Employment. Bregman:Luitpold: Employment.

scholarly journals A study of efficacy of oral iron and intravenous iron sucrose in the treatment of moderate anemia in pregnancy

2019 ◽  
Vol 8 (6) ◽  
pp. 2221
Author(s):  
Saloni M. Prajapati ◽  
Meha K. Patel
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Deficiency Anaemia ◽  
Blood Indices ◽  
In Pregnancy

Background: Iron deficiency anaemia in pregnancy is a common medical problem throughout India with the burden of disease impacting on both mother and the newborn. It is also responsible for increased incidence of premature births, low birth weight babies and high perinatal mortality. Intravenous iron sucrose and oral iron therapy are the primary therapeutic modalities for management of iron deficiency anaemia during pregnancy, but its efficacy during pregnancy is still a matter of argument among healthcare personnel. Therefore the objective of this study is to compare the effect of oral iron and intravenous iron sucrose on hemoglobin and other blood indices among pregnant females with iron deficiency anemia.Methods: Randomized clinical trial was conducted among 400 females between 20 to 34 weeks gestation with iron deficiency anemia who were managed either with oral ferrous sulphate or intravenous iron sucrose therapy. Z test was used for statistical analysis for significance with 95% confidence interval. The hemoglobin and blood indices levels before and after initiating treatment in both groups were compared.Results: Intravenous and oral; both the treatments were associated with increment in hemoglobin but this rise was significantly more in the intravenous group than in oral. Comparing participants with low pretreatment hemoglobin among both groups, participants in the intravenous group were better benefited than oral due to respective treatment.Conclusions: Intravenous iron therapy is much effective in correcting iron deficiency anemia in pregnancy than oral iron therapy. It restores iron stores more promptly. Also intravenous iron is better tolerated compared to oral iron.

scholarly journals Effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in pregnancy

2018 ◽  
Vol 7 (5) ◽  
pp. 1908
Author(s):  
Devdatt Laxman Pitale
Keyword(s):  
Side Effects ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Age Group ◽  
Oral Iron Therapy ◽  
The Mean ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Background: Anaemia in pregnancy is very common throughout our country impacting both mother and the newborn. The most common cause of anaemia in pregnancy is iron deficiency. The increased prevalence of iron deficiency anaemia amongst the pregnant women, especially in developing countries is a major cause of significant maternal morbidity and mortality. Intolerance to oral iron, inadequate absorption, and side effects leading to poor compliance are the major shortcomings in oral iron therapy. These factors are significant especially in anaemia near term. To overcome all these limiting factors associated with oral iron therapy, parenteral iron therapy is preferred. Aim of this study was to study effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in pregnancy.Methods: This prospective study was taken up to compare the effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in 30 antenatal women attending antenatal outpatient Department of Obstetrics and Gynaecology belonging to gestational age group of 28-34 weeks with anaemia in pregnancy.Results: Majority of pregnant women belonged to age group of 22-25 years.67% were primigravidas. The period of gestation varied from 28-34 weeks. In this study, the mean baseline haemoglobin was 8.4 g/dl before start of treatment and after iv iron sucrose treatment haemoglobin showed a mean value of 10.8g/dl. The mean baseline MCV was 70 fl/cell. Post treatment MCV after 4 weeks showed a significant mean rise of 12 fl/cell in the present study with no major side effects.Conclusions: Intravenous iron sucrose is highly effective over oral iron therapy for anaemia in pregnancy. It enables rapid correction of anaemia with minimal side effects.

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