Safety of intravenous iron isomaltoside for iron deficiency and iron deficiency anemia in pregnancy

Wesström, Jan

doi:10.1007/s00404-020-05509-2

Cited by 24 publications

(18 citation statements)

References 22 publications

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“…Iron proteinsuccinylate is a widely used iron supplement in clinical practice, which can effectively improve the iron deficiency in children. However, iron deficiency anemia in children is a comprehensive metabolic disease, and the treatment of simply supplementing iron has certain limitations [ 17 , 18 ]. Therefore, it is of positive significance to select a reasonable treatment for children with iron deficiency anemia.…”

Section: Discussionmentioning

confidence: 99%

[Retracted] Changes of Serum Ferritin, Hemoglobin, and Serum Iron (SI) and Treatment Effect of Iron Proteinsuccinylate Oral Solution Combined with Vitamin A and D Drops on Children with Nutritional Iron Deficiency Anemia

Yan-bo

Zhang

et al. 2022

BioMed Research International

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Objective. The purpose was to evaluate the treatment effect of iron proteinsuccinylate oral solution combined with vitamin A and D drops on children with nutritional iron deficiency anemia. Methods. 124 children treated in the outpatient department of our hospital from January 2017 to January 2020 were selected as the study subjects. They were randomly divided into control and observation two groups. The control group was treated with iron proteinsuccinylate oral solution (1.5 mL/kg) in the morning and evening, respectively. The observation group received adjuvant treatment with oral vitamin A and D drops based on the treatment of the control group. The treatment effect of proteinsuccinylate oral solution combined with vitamin A and D drops was evaluated by the serum iron (SI), serum ferritin (SF), and transferrin (TRF) levels, the values of CD3+, CD4+, and CD4+/CD8+, and other evaluation indicators. Results. After treatment, the SI and SF levels of children in both groups significantly increased ( P < 0.01 ) while the TRF level significantly decreased ( P < 0.01 ), and the SI and SF levels in the observation group increased more significantly, and the TRF level decreased more significantly compared with those in the control group ( P < 0.01 ). After treatment, the values of CD3+, CD4+, and CD4+/CD8+ of children in both groups significantly increased compared with those before treatment ( P < 0.01 ), and the values of CD3+, CD4+, and CD4+/CD8+ increased more significantly in the observation group compared with those in the control group ( P < 0.01 ). In addition, the evaluation results of treatment effect showed that the markedly effective rate in the observation group was significantly higher than that in the control group ( P < 0.01 ). Conclusion. Iron proteinsuccinylate oral solution combined with vitamin A and D drops can better improve the anemia symptoms in children, with high application value.

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Section: Discussionmentioning

confidence: 99%

[Retracted] Changes of Serum Ferritin, Hemoglobin, and Serum Iron (SI) and Treatment Effect of Iron Proteinsuccinylate Oral Solution Combined with Vitamin A and D Drops on Children with Nutritional Iron Deficiency Anemia

Yan-bo

Zhang

et al. 2022

BioMed Research International

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“…Intravenous iron substitution to compensate for iron deficiency confirmed by laboratory tests is more effective than oral substitution 39 . The findings of an American meta-analysis carried out in the same year 2019 were similar, with intravenous iron administration found to be more effective and to have fewer side effects compared to peroral iron substitution 40 , 41 .…”

Section: Iron Supplementationmentioning

confidence: 81%

Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG)

Fischer

Helmer

Klaritsch

et al. 2022

Geburtshilfe Frauenheilkd

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This overview analyzes the data on the controversial therapy of iron substitution during pregnancy, the diagnosis of iron deficiency anemia and the indication-related therapy, and is the first recommendation issued by the OEGGG on the appropriate therapy. The effects of anemia during pregnancy on postnatal outcomes have been intensively investigated with heterogeneous results. A final scientific conclusion with regards to the “optimal” maternal hemoglobin level is limited by the heterogeneous results of various studies, many of which were conducted in emerging nations (with different dietary habits and structural differences in the respective healthcare systems). The current literature even suggests that there may be a connection between both decreased and increased maternal serum hemoglobin concentrations and unfavorable short-term and long-term neonatal outcomes. In Austria, 67 percent of pregnant women take pharmacological supplements or use a variety of dietary supplements. Clinically, the prevalence of maternal anemia is often overestimated, leading to overtreatment of pregnant women (iron substitution without a medical indication). To obtain a differential diagnosis, a workup of the indications for treatment should be carried out prior to initiating any form of iron substitution during pregnancy. If treatment is medically indicated, oral iron substitution is usually sufficient. Because of the restricted approval and potential side effects, medical indications for intravenous iron substitution should be limited. Intravenous iron substitution without a prior detailed diagnostic workup is an off-label use and should only be used in very limited cases, and women should be advised accordingly.

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“…Likewise, the safety profile of new intravenous iron formulations for pregnant women is also good 32 , but mild reactions are also not uncommon. In pregnant women who received iron isomaltoside (Monofer), 4.7% developed mild hypersensitivity, which abated spontaneously, and none had severe reactions or anaphylaxis 33 . In Danish postpartum women, iron isomaltoside (Monofer) was well tolerated, with a mild adverse drug event rate of 13.3%, mostly related to infusion site 34 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of intravenous iron isomaltoside in postpartum anaemia

Lee

Shu

2022

Hong Kong Journal of Gynaecology, Obstetrics and Midwifery

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Background: Postpartum anaemia adversely affects maternal mood, cognition, and maternal-infant interactions. Intravenous iron isomaltoside is effective and safe for non-pregnant patients with iron deficiency anaemia, but data on its use in Hong Kong women during peripartum period are limited. This study aims to determine the effectiveness and safety of iron isomaltoside (Monofer) in women with postpartum haemorrhage or anaemic symptoms. Methods: Records of women who received iron isomaltoside (Monofer) when haemoglobin (Hb) level was <7g/dL (or ≥7g/dL when concomitant with anaemic symptoms) irrespective of mode of delivery between April 2018 and March 2021 were reviewed. Primary outcome measures included response to iron isomaltoside treatment (measured by pre-and post-treatment Hb levels), resolution of anaemic symptoms, and the number and types of adverse reactions related to treatment. Secondary outcome measures included associations between patient characteristics and Hb response. Results: 126 women were included for analysis. Most were nulliparous, delivered vaginally, and had minor postpartum haemorrhage. Most had a baseline Hb level of <10.0 (mean, 7.36) g/dL, but only 53.2% of them had anaemic symptoms. No women experienced serious adverse events. Only four (3.2%) women had mild adverse events of rash (n=3) or pruritis (n=1). At the 6-week follow-up, the mean Hb level increased 4.39 g/dL to 11.8 g/dL (p<0.001), with only one woman reporting anaemic symptoms. 12 (9.5%) of 126 women had some form of haemoglobinopathy (usually thalassemia trait) and had lower Hb levels even before pregnancy. Compared with women with normal Hb pattern, women with haemoglobinopathy had lower post-treatment Hb responses (p=0.001). Hb response was positively associated with delivery blood loss (r=0.188) and negatively associated with baseline Hb level (r= -0.279). Conclusion: Iron isomaltoside (Monofer) is effective and safe for postpartum anaemia. It enables rapid improvement in Hb level and anaemic symptoms, even for those with haemoglobinopathy.

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Safety of intravenous iron isomaltoside for iron deficiency and iron deficiency anemia in pregnancy

Cited by 24 publications

References 22 publications

[Retracted] Changes of Serum Ferritin, Hemoglobin, and Serum Iron (SI) and Treatment Effect of Iron Proteinsuccinylate Oral Solution Combined with Vitamin A and D Drops on Children with Nutritional Iron Deficiency Anemia

[Retracted] Changes of Serum Ferritin, Hemoglobin, and Serum Iron (SI) and Treatment Effect of Iron Proteinsuccinylate Oral Solution Combined with Vitamin A and D Drops on Children with Nutritional Iron Deficiency Anemia

Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG)

Efficacy and safety of intravenous iron isomaltoside in postpartum anaemia

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