Intravenous iron sucrose is superior to oral iron sulphate for correcting anaemia and restoring iron stores in IBD patients: A randomized, controlled, evaluator-blind, multicentre study

Lindgren, Stefan; Wikman, Ola; Befrits, Ragnar; Blom, Håkan; Eriksson, Anders; Grännö, Christer; Ung, Kjell-Arne; Hjortswang, Henrik; Lindgren, Anders; Unge, Peter

doi:10.1080/00365520902839667

Cited by 155 publications

(163 citation statements)

References 24 publications

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“…In the presence of chronic bowel inflammation, activated T lymphocytes diminish even more oral iron absorption. Furthermore, less than half of the patients with IBD that receive oral iron supplementation tolerate the entire dose that is necessary to restore their iron deposits and normalize hemoglobin levels [19,20]. Intravenous iron substitution is recommended for patients that require rapid hemoglobin correction, for cases of severe anemia and for those that are taking erythropoiesis stimulating agents (ESA).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia and Iron Deficiency in Romanian Patients with Inflammatory Bowel Disease: a Prospective Multicenter Study

Lupu

Diculescu

Diaconescu

et al. 2015

JGLD

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Background & Aims: Anemia is the most frequent systemic complication in inflammatory bowel diseases. It affects the quality of life and can interact with working capacity. Our objectives were to identify the prevalence of anemia, its main causes and its management in patients with inflammatory bowel disease from Romania.Methods: We conducted a multicenter prospective study from March 2013 to August 2014. We enrolled 291 patients from three referral centers: 115 (39.52%) with Crohn's disease (CD) and 176 (60.48%) with ulcerative colitis (UC). We defined anemia according to the WHO criteria.Results: Median age of the patients was 41 years and the median time period since diagnosis was 3 years (0.75-7). The median activity index for UC (UCAI) was 4 and the median CD activity index (CDAI) was 96. More patients with CD were on antiTNFα therapy (p < 0.01), corticosteroids (p =0.18) or azathioprine (p=0.05) and required surgery for their underlying disease at study enrollment (p < 0.01). Anemia was present in 31.27% of the patients, more often in those with CD (35.65%) than with UC (28.41%) (not statistically significant); 53.26% of the patients had iron deficiency while 4.12% had folic acid and 8.59% vitamin B12 deficiency; 9.62% of the patients had received anti-anemic therapy at inclusion in the study or in the last three months prior to study enrollment.Conclusions: About one in three Romanian patients with inflammatory bowel disease has anemia, which is frequently associated with iron deficiency. About 30% of the patients with anemia are under therapy and the most frequent route for iron supplementation is the oral one. This might contribute to the high prevalence of iron deficiency and the low level of compliance.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia and Iron Deficiency in Romanian Patients with Inflammatory Bowel Disease: a Prospective Multicenter Study

Lupu

Diculescu

Diaconescu

et al. 2015

JGLD

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“…4 The authors' defence based on consistency and heterogeneity 5 does not hold across the network as iron isomaltoside was only connected to the network by a single study and consistency and heterogeneity tests are therefore inapplicable.…”

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confidence: 99%

Letter: the importance of dosing and baseline haemoglobin when establishing the relative efficacy of intravenous iron therapies

Reinisch

Lindgren

2017

Aliment Pharmacol Ther

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“…In addition to these many women complain that oral iron syrups have an unpalatable metallic taste that is difficult to consume and induce aesthetic problems like gradual blackish discolouration of teeth. 7 Despite repeated counseling a significant number of antenatal women either consume these oral medications bizarrely and many even ultimately discontinue them leading to depleted iron stores and mostly maternal anemia. Once anemia develops therapeutic parenteral iron therapy and blood transfusions as required are administered to the mother.…”

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confidence: 99%

Parenteral iron prophylaxis: a convenient alternative for antenatal women who do not consume oral iron

Rai

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPregnancy is a delicate stage in a woman's life where her nutritional demands completely change. She has to keep up to the increased requirement of several nutrients. Of a special mention is iron which plays a pivotal role in maintaining the health of both mother and the fetus. The daily iron requirement for an antenatal woman is 4-6mg/day in second trimester and that in third trimester is 10-12mg/day. 1 This high requirement is difficult to meet ABSTRACT Background: A large number of antenatal women have difficulty consuming oral iron due to its well-known side effects. A simple alternative for it needs to be found. Aim and objective was to study the efficacy of parenteral iron prophylaxis as an alternative for antenatal women who are not able to consume oral iron. Methods: A prospective case control study was conducted at a tertiary care centre in Hyderabad city, India from March 2016-March 2017. 73 non-anemic antenatal women between 14-24 weeks who were not taking oral iron supplementation were identified. 39 of them were willing for parenteral iron supplementation were included in Cases group and 34 who were not taking iron supplementation in any form were controls. Cases were administered three doses of IV Iron sucrose 200mg in 100 ml normal saline between 24-28 weeks, 28 -32 weeks and 35-37 weeks Hemoglobin was checked again at 32weeks, 36 weeks, just prior to and on 3 rd day post-delivery. Data obtained was analyzed using SPSS software. Results: 67% of antenatal women discontinued oral iron due to its gastric side effects. No bias took place during selection of cases and controls. 7.69% of the 'cases group' developed anemia despite parenteral prophylaxis. All of them were diagnosed as mild anemia. 70.59% of the 'controls group' developed anemia eventually of which 8 were mild, 13 were moderate, 3 were severe and none were very severe. Mostly women became anemic after delivery. About 59% of antenatal women in cases group had no adverse effects with Iron Sucrose Injections, 8 of them had itching or rash and 9 of them complained of brownish discoloration of urine.11 of them had pain at the infusion site and only 1 of them had fever on administering parenteral therapy. None of these were severe enough to cause discontinuation of parenteral iron administration. No statistically significant difference could be found in maternal and perinatal morbidity and mortality between the two groups. The mean cost of parenteral iron prophylaxis was Rs. 1650. Conclusions: Women who do not take oral Iron supplementation in pregnancy are more prone to develop anemia subsequently. The commonest cause of non-compliance to oral iron is gastric intolerance. 3 doses of Intravenous Iron Sucrose 200mg prevents anemia in antenatal women who do not take oral iron supplementation. Hence, it can now be considered a convenient option for them.

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Intravenous iron sucrose is superior to oral iron sulphate for correcting anaemia and restoring iron stores in IBD patients: A randomized, controlled, evaluator-blind, multicentre study

Abstract: Treatment with intravenous iron sucrose is effective, safe, well tolerated and superior to oral iron in correcting haemoglobin and iron stores in patients with IBD.

Cited by 155 publications

References 24 publications

Prevalence of Anemia and Iron Deficiency in Romanian Patients with Inflammatory Bowel Disease: a Prospective Multicenter Study

Prevalence of Anemia and Iron Deficiency in Romanian Patients with Inflammatory Bowel Disease: a Prospective Multicenter Study

Letter: the importance of dosing and baseline haemoglobin when establishing the relative efficacy of intravenous iron therapies

Parenteral iron prophylaxis: a convenient alternative for antenatal women who do not consume oral iron

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