RETRACTED ARTICLE: Total dose iron dextran infusion versus oral iron for treating iron deficiency anemia in pregnant women: a randomized controlled trial

Darwish, Atef M.; Khalifa, Eiman; Rashad, Essam; Farghally, Essam

doi:10.1080/14767058.2017.1379988

Cited by 18 publications

(26 citation statements)

References 14 publications

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“…Our search strategy resulted in 11 open-label RCT studies for inclusion in the metaanalysis. [15][16][17][18][19][20][21][22][23][24][25] We did not identify any blinded RCT studies for inclusion. One author (S.G.) extracted data from included RCT studies, using a standardized data abstraction form.…”

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

“…Individual studies varied in their diagnostic inclusion criteria for iron-deficiency anemia, as determined by upper limit of normal for hemoglobin and ferritin determinations. For our primary analysis, we allowed these variations, for hemoglobin (7 studies < 7-10 g/dL, 15,16,18,[21][22][23]25 2 studies < 10.5 g/dL, 17,20 and 2 studies < 11.0 g/dL 19,24 ) and ferritin (6 studies < 12-15 ug/L, 16,17,19,22,23,25 1 study < 20 ug/L, 20 1 study < 27 ug/L, 24 1 study < 50 ug/L, 18 and 1 study not stated 15 ). We performed a subgroup analysis to compare changes in hemoglobin levels among subjects with baseline (pretreatment) hemoglobin < 8.0 g/dL versus those with hemoglobin > 8.0 g/dL.…”

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

“…Iron sucrose was the IV iron formulation administered in all studies except 2. 20,21 One study utilized ferric carboxymaltose (FCM), 20 and another utilized low molecular weight (LMW) iron dextran. 21 Sensitivity analyses were performed to account for variation in IV iron formulation between studies.…”

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

“…20,21 One study utilized ferric carboxymaltose (FCM), 20 and another utilized low molecular weight (LMW) iron dextran. 21 Sensitivity analyses were performed to account for variation in IV iron formulation between studies. In studies of IV iron sucrose and LMW iron dextran, the dose (mg/kg) was calculated using a standard formula using the patient's weight and estimated iron stores (500 mg): actual weight (kg) Â (target hgb-actual hgb in g/dL) Â 0.24 þ 500 mg. Doses were rounded up to the nearest multiple of 100 mg. Target hemoglobin was 11 g/dL or 12 g/dL.…”

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

“…In the study by Bayoumeu et al, 18 women were given 6 infusions on days 1, 4, 8, 12, 15, and 21. Breymann et al 20 administered IV iron FCM at a dose of 1,000 mg once a week, while Darwish et al 21 administered LMW iron dextran as a one-time, total dose infusion.…”

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

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Treatment of Iron Deficiency Anemia in Pregnancy with Intravenous versus Oral Iron: Systematic Review and Meta-Analysis

Govindappagari

Burwick

2018

Amer J Perinatol

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Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

Section: Eligibility Criteria Information Sources Search Strategymentioning

confidence: 99%

See 3 more Smart Citations

Treatment of Iron Deficiency Anemia in Pregnancy with Intravenous versus Oral Iron: Systematic Review and Meta-Analysis

Govindappagari

Burwick

2018

Amer J Perinatol

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Risk of Infection Associated With Administration of Intravenous Iron

et al. 2021

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IMPORTANCEIntravenous iron is recommended by many clinical guidelines based largely on its effectiveness in reducing anemia. However, the association with important safety outcomes, such as infection, remains uncertain. OBJECTIVE To examine the risk of infection associated with intravenous iron compared with oral iron or no iron. DATA SOURCES Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for randomized clinical trials (RCTs) from 1966 to January 31, 2021. Ongoing trials were sought from ClinicalTrials.gov, CENTRAL, and the World Health Organization International Clinical Trials Search Registry Platform. STUDY SELECTION Pairs of reviewers identified RCTs that compared intravenous iron with oral iron or no iron across all patient populations, excluding healthy volunteers. Nonrandomized studies published since January 1, 2007, were also included. A total of 312 full-text articles were assessed for eligibility. DATA EXTRACTION AND SYNTHESIS Data extraction and risk of bias assessments were performed according to the Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) and Cochrane recommendations, and the quality of evidence was assessed using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach. Two reviewers extracted data independently. A random-effects model was used to synthesize data from RCTs. A narrative synthesis was performed to characterize the reporting of infection. MAIN OUTCOMES AND MEASURESThe primary outcome was risk of infection. Secondary outcomes included mortality, hospital length of stay, and changes in hemoglobin and red blood cell transfusion requirements. Measures of association were reported as risk ratios (RRs) or mean differences.RESULTS A total of 154 RCTs (32 920 participants) were included in the main analysis. Intravenous iron was associated with an increased risk of infection when compared with oral iron or no iron (RR, 1.17; 95% CI, 1.04-1.31; I 2 = 37%; moderate certainty of evidence). Intravenous iron also was associated with an increase in hemoglobin (mean difference, 0.57 g/dL; 95% CI, 0.50-0.64 g/dL; I 2 = 94%) and a reduction in the risk of requiring a red blood cell transfusion (RR, 0.93; 95% CI, 0.76-0.89; I 2 = 15%) when compared with oral iron or no iron. There was no evidence of an effect on mortality or hospital length of stay. (continued) Key Points Question In patients who require treatment with intravenous iron, what is the evidence that this intervention increases the risk of developing a new infection? Findings In this systematic review and meta-analysis of 154 randomized clinical trials that included 32 920 participants, intravenous iron was associated with an increased risk of infection. Meaning The results of this study suggest that, despite broad advocacy in clinical guidelines, intravenous iron may increase the risk of infection, which must be balanced with the potential benefits of treating anemia and reducing blood transfusion requirements.

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A retrospective study of the safety and efficacy of low molecular weight iron dextran for children with iron deficiency anemia

Boucher

Bedel

Jones

et al. 2021

Pediatric Blood & Cancer

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Background: Iron deficiency anemia (IDA) affects millions of children worldwide. Oral iron replacement is effective but often poorly tolerated. Intravenous iron has been demonstrated to have utility in all ages, but pediatric use remains limited. Low molecular weight iron dextran (LMWID) has a dosing range capable of replacing iron deficits in a single infusion and has been evaluated in small pediatric cohorts, but additional safety and efficacy data are limited. Here, we evaluate the safety and efficacy of LMWID in association with an electronic medical record (EMR)-based effort to optimize dosing.Procedure: A retrospective IRB-approved investigation of LMWID utilization at a tertiary pediatric hospital between January 1, 2016 and March 31, 2020 was undertaken to evaluate the therapeutic efficacy and frequency/severity of infusion-related adverse event (AE) in children and adolescents receiving LMWID. Patient demographics and LMWID dosing characteristics were collected, and primary outcome measures included laboratory response and the incidence/severity of any infusionrelated events. The utilization of an EMR-based nomogram for LMWID dosing was also evaluated.Results: A total of 254 infusions for 191 patients were included (ages 0.7-20.9 years), most with IDA. LMWID replaced at least 75% of the estimated iron deficit in a single infusion for 76% of patients. The mean hemoglobin and ferritin increases were 2.1 g/dl and >100 ng/ml, respectively. Infusion-related AEs were rare, occurring in only 12/254 (4.7%) of infusions and 67% during the test dose; each rapidly resolved without longterm sequelae. No AEs occurred in those <10 years of age. Premedication use markedly decreased with nomogram use without a change in AE rate. Conclusions:In a large institutional cohort, LMWID was well tolerated in children and adolescents, with most patients having their total iron deficits relieved in a single infusion. These data support expanded use of LMWID in the management of pediatric iron deficiency.

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RETRACTED ARTICLE: Total dose iron dextran infusion versus oral iron for treating iron deficiency anemia in pregnant women: a randomized controlled trial

Cited by 18 publications

References 14 publications

Treatment of Iron Deficiency Anemia in Pregnancy with Intravenous versus Oral Iron: Systematic Review and Meta-Analysis

Treatment of Iron Deficiency Anemia in Pregnancy with Intravenous versus Oral Iron: Systematic Review and Meta-Analysis

Risk of Infection Associated With Administration of Intravenous Iron

A retrospective study of the safety and efficacy of low molecular weight iron dextran for children with iron deficiency anemia

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