A comparative study of efficacy and safety of intravenous ferric carboxymaltose versus iron sucrose in the treatment of iron deficiency anaemia of pregnancy in a tertiary care hospital

Abstract

Background: Anaemia is a global public health problem. To optimize iron delivery in pregnancy, new intravenous complexes like Ferric carboxymaltose (FCM) have been developed in the few years. This study aims to compare the efficacy and safety of FCM vs the iron sucrose during pregnancy.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, Shri Maharaja Gulab Singh (S.M.G.S.) Hospital, Government Medical College Jammu, Jammu and Kashmir over a period of 1 year. 100 pregnant females with haemoglobin (Hb) in the range 7-9.9 g/dl between 28 to 36-week gestation, were selected randomly out of which 50 were administered FCM (Group A) and 50 were administered Iron Sucrose (Group B). Hb and serum ferritin were assessed 2 weeks and 4 weeks after treatment and side effects of each drug was studied.Results: The rise in mean Hb level at 2 weeks and 4 weeks in FCM group was significantly higher as compared to Iron Sucrose group (1.09 versus 0.52 g/dl and 1.80 versus 1.09 g/dl, respectively). Similarly, the rise in mean serum ferritin level at 2 weeks and 4 weeks was more in FCM as compared to Iron Sucrose group (144.25 vs 95.84 mcg/L and 121.31 vs 84.46 mcg/L, respectively). The adverse reactions were observed in 30% of patients in FCM group and 48% patients in iron sucrose group.Conclusions: Ferric carboxymaltose was found to be more safe and efficacious as compared to iron sucrose.

Comparison of efficacy of injection ferric carboxymaltose and iron sucrose in moderate anaemia in pregnancy

“…On administering, it allows for controlled delivery of iron within the cells of the reticuloendothelial system and subsequent delivery to the iron-binding proteins ferritin and transferrin, with minimal risk of release of large amounts of ionic iron in the serum thus allows rapid administration of high doses of iron in a single sitting. 5 We observed higher increase in haemoglobin in FCM group than iron sucrose group at each point of measurement. The mean rise in haemoglobin values from baseline in the FCM group was 0.20±0.06 at 3 rd day, 2.03±0.47 at 3 weeks, 3.86±0.53 at 12 weeks compared to iron sucrose group, which was 0.11±0.08 at 3 rd day, 1.51±0.39 at 3 weeks, and 3.22±0.54 at 12 weeks, which was statistically significant and showed that the haemoglobin levels were increased more in FCM group.…”

Clinical effectiveness of ferric carboxymaltose (iv) versus iron sucrose (iv) in treatment of iron deficiency anaemia in pregnancy: A systematic review and meta-analysis

“…1 ). A total of 18 articles that addressed one or more of the outcomes were included of which seven studies compared iv FCM and iv ISC (five RCTs 7 16 17 18 19 and two retrospective audits) 20 21 and 11 were observational studies 22 23 24 25 26 27 28 29 30 31 32 on safety and effectiveness of iv FCM.…”

“…Out of the five RCTs, four were conducted in India 7 16 17 19 and one in Pakistan 18 . One retrospective audit each from Switzerland 20 and Australia 21 were included.…”

“…All the RCTs reported a rise in Hb and serum ferritin levels with an average follow up period of six and a half weeks (one week to 20 wk). Four RCTs 7 16 17 19 reported the incidence of adverse events that happened during iv iron treatment. One study 7 reported pregnancy and neonatal outcomes such as preterm birth, spontaneous abortion and the birth weight of the newborn.…”

“…The data regarding blood transfusion requirement due to IDA are given in only one study 21 comparing iv FCM and iv ISC. One study 16 has excluded pregnant women with a history of blood transfusion in the past and those with anticipated need for blood transfusion. Other studies do not mention any data on blood transfusion.…”