The efficiency and safety of Shengxuening tablet on treating and preventing iron deficiency anemia: A systematic review and meta-analysis

Abstract

Background: Iron deficiency anemia (IDA) is a public health problem worldwide. Shengxuening Tablet (SXN) has been used for the treatment of various types of anemia, attaining high efficacy.Objective: To evaluate the safety of SXN as well as its preventive and therapeutic efficacy against IDA across different population groups.Methods: PubMed, Embase, Web of Science, the Cochrane Library, the China Knowledge Network, the China Biomedical Literature Database, the Wanfang Data Knowledge Service Platform, and the China Science and Technology Journal Database was searched for relevant clinical trials through June 2022 and a systematic review and meta-analysis of the identified studies was undertaken.Results: A total of 39 trials involving 4,562 cases were included in the meta-analysis. The total efficiency of SXN was superior than the control group in improving red blood cell (RBC) count [SMD = 1.31, 95% CI (0.7, 1.91), p < 0.0001], hemoglobin (Hb) [SMD = 1.11, 95% CI (0.75, 1.46), p < 0.00001], mean corpuscular volume (MCV) [SMD = 0.5, 95% CI (0.33, 0.68), p < 0.00001], total serum iron (SI) levels [SMD = 1.87, 95% CI (1.3, 2.44), p < 0.00001], and transferrin saturation (TSAT) levels [SMD = 2.07, 95% CI (1.86, 2.27), p < 0.00001]. Besides, the total effects of SXN to improve mean corpuscular hemoglobin (MCH) [SMD = 0.12, 95% CI (−0.16, 0.4), p = 0.41], mean corpuscular hemoglobin concentration (MCHC) [SMD = 0.03, 95% CI (−0.18, 0.24), p = 0.77], hematocrit (HCT) [SMD = 0.65, 95% CI (−0.25, 1.55), p = 0.16], and serum ferritin (SF) levels [SMD = 0.59, 95% CI (−0.67, 1.85), p = 0.36] and reduce the total iron binding capacity (TIBC) [SMD = 0.34, 95% CI (−0.07, 0.74), p = 0.1] was comparable to that of iron supplementation. SXN significantly raised the total effective rates of IDA [risk ratio (RR) = 1.06, 95% CI (1.02, 1.09), p = 0.0005] and was associated with fewer adverse events [RR = 0.24, 95% CI (0.18, 0.31), p < 0.00001], fewer adverse pregnancy outcomes [RR = 0.34, 95% CI (0.2, 0.57), p < 0.0001], and lower anemia recurrence rates during pregnancy [RR = 0.29, 95% CI (0.1, 0.84), p = 0.02]. Regarding prevention, the effects of SXN to maintain the RBC count, Hb level and other IDA-related parameters were comparable to that of control group and SXN reduced the risk of IDA incidence during pregnancy.Conclusion: SXN demonstrated promising efficacy in the treatment and prevention of IDA and outperformed routine iron formulations in terms of safety, thus rendering SXN a reliable treatment option for IDA.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42022353247.

Tailored pharmacist-led intervention to improve adherence to Iron supplementation in premature infants: a randomized controlled trial in China

“…In order to ensure accurate measures for these outcomes, the study team underwent a decade of training and standardization in monitoring baby growth. Numerous studies have been conducted on both animal models and newborn humans to determine the relationship between iron deficiency and unfavorable outcomes in the near, medium, and long terms ( 28 – 30 ). With specific areas of impairment connected to brain regions that appeared to be most negatively impacted by iron deficiency, including myelination and the hippocampus.…”

Safety and efficacy of East Asian herbal medicine for iron deficiency anemia in children and adolescents: a systematic review and meta-analysis

“…Additionally, continuous treatment is required for at least 3 months after anemia is corrected, which can lead to poor compliance in children and act as a barrier to successful oral iron therapy ( Powers et al, 2016 ). Recent studies have shown that the administration of herbal medicines (HMs) to children with IDA effectively improves IDA-related hematological markers ( Li et al, 2022 ; Zhang et al, 2022 ). Two systematic reviews have reported on the treatment of IDA with botanical drugs ( Li et al, 2022 ; Zhang et al, 2022 ); however, neither focused on children, but on pregnant women or on the entire population.…”

“…Recent studies have shown that the administration of herbal medicines (HMs) to children with IDA effectively improves IDA-related hematological markers ( Li et al, 2022 ; Zhang et al, 2022 ). Two systematic reviews have reported on the treatment of IDA with botanical drugs ( Li et al, 2022 ; Zhang et al, 2022 ); however, neither focused on children, but on pregnant women or on the entire population. Furthermore, they only analyzed the therapeutic effects of Shengxuening tablets, which were known to remove blood stasis, replenish qi and nourish blood ( Li et al, 2022 ; Zhang et al, 2022 ).…”

“…Two systematic reviews have reported on the treatment of IDA with botanical drugs ( Li et al, 2022 ; Zhang et al, 2022 ); however, neither focused on children, but on pregnant women or on the entire population. Furthermore, they only analyzed the therapeutic effects of Shengxuening tablets, which were known to remove blood stasis, replenish qi and nourish blood ( Li et al, 2022 ; Zhang et al, 2022 ). Since there has been no systematic review evaluating the overall efficacy of HM focusing on children, this meta-analysis aimed to evaluate the safety and efficacy of East Asian botanical drugs for IDA in children and adolescents.…”