Intravenous iron sucrose versus oral iron ferrous sulfate for antenatal and postpartum iron deficiency anemia: a randomized trial

Froessler, Bernd; Cocchiaro, Carmel; Saadat-Gilani, Khaschayar; Hodyl, Nicolette A.; Dekker, Gustaaf A.

doi:10.3109/14767058.2012.746299

Cited by 92 publications

(123 citation statements)

References 18 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…13 Among other comparative studies, none demonstrated any statistically significant differences between groups across any perinatal outcomes investigated, including birth weight, gestational age, method of delivery, and postpartum haemorrhage. 11,14,16,24,30,31,37,38,54,56 Notably, the small study samples included in each of these studies limited the statistical power to detect clinically relevant differences between the two groups.…”

Section: Perinatal Outcomesmentioning

confidence: 99%

“…11,13,16,20,[22][23][24][25]27,31,32,34,36,38,40,44,49 Across all studies, the median reported prevalence of ADRs was similar among prospective (4.5%) 11,16,19,20,22,23,27,29,31,32,34,36,38,40,44,49,53,[55][56][57] and retrospective (5%) 13,52,54 studies. Eighteen studies administered a test dose, 15,23,[25][26][27][28][29][30][31]34,37,…”

Section: Tolerabilitymentioning

confidence: 99%

“…The majority of studies involved a comparison group of some kind including oral iron (n = 17; 36%), 11,14,16,19,24,26,27,29,31,32,34,35,37,39,50,56,57 IV iron (n = 4; 9%), 13 [14][15][16]18,20,24,26,28,31,[33][34][35][36][37][38][39]41,42,44,49,50,53 Only one study was identified that directly compared the administration of a full replacement dose of IV iron to a dose that was 300 mg less than the calculated full replacement dose. In comparing the two groups, administration of the full replacement dose was associated with a greater increase of 8 g/L 3-4 weeks after administration and 14 g/L at delivery.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…Compared to oral iron, use of IV iron was associated with a greater increase in haemoglobin at 2-4 weeks following the infusion (median: 6 g/L; range: 1-20 g/L) 11,16,26,27,29,31,34,35,37,39,50,56 and at delivery (median: 6.8 g/L; range: 6-19 g/L). 14,16,32,56 When examining ferritin at 4 weeks, seven of eight studies demonstrated a greater median increase of 38 μg/L (range: 25-222 μg/L) among the group receiving IV rather than oral therapy.…”

mentioning

confidence: 99%

“…14,16,32,56 When examining ferritin at 4 weeks, seven of eight studies demonstrated a greater median increase of 38 μg/L (range: 25-222 μg/L) among the group receiving IV rather than oral therapy. 11,24,26,27,35,37,50,56 Only two studies reported on difference in ferritin at deliv- …”

mentioning

confidence: 99%

See 4 more Smart Citations

Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Qassim

Mol

Grivell

et al. 2017

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

Background: Intravenous (IV) iron in pregnancy is useful where oral iron is not tolerated or a rapid replenishment of iron is required. Aims:To review the literature on the efficacy and safety of different IV iron preparations in the management of antenatal iron-deficiency anaemia (IDA). Materials and methods:We searched MEDLINE, Embase and Scopus from inception to June 2016. Eligible studies were randomised controlled trials (RCTs) and observational studies, involving administration of IV iron (ferric carboxymaltose (FCM), iron polymaltose (IPM) or iron sucrose (IS)), regardless of comparator, to manage antenatal IDA. Two independent reviewers selected studies, extracted data and assessed quality.

show abstract

Section: Perinatal Outcomesmentioning

confidence: 99%

Section: Tolerabilitymentioning

confidence: 99%

Section: Overview Of Included Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Qassim

Mol

Grivell

et al. 2017

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

show abstract

Risk of Infection Associated With Administration of Intravenous Iron

et al. 2021

View full text Add to dashboard Cite

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.

show abstract

Treatment for women with postpartum iron deficiency anaemia

Markova

Nørgaard

Jørgensen

et al. 2015

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

The body of evidence did not allow us to reach a clear conclusion regarding the efficacy of the interventions on postpartum iron deficiency anaemia. The quality of evidence was low.Clinical outcomes were rarely reported. Laboratory values may not be reliable indicators for efficacy, as they do not always correlate with clinical treatment effects. It remains unclear which treatment modality is most effective in alleviating symptoms of postpartum anaemia.Intravenous iron was superior regarding gastrointestinal harms, however anaphylaxis and cardiac events occurred and more data are needed to establish whether this was caused by intravenous iron.The clinical significance of some temporarily improved fatigue scores in women treated with blood transfusion is uncertain and this modest effect should be balanced against known risks, e.g. maternal mortality (not reported) and maternal immunological sensitisation, which can potentially harm future pregnancies.When comparing oral iron to placebo it remains unknown whether efficacy (relief of anaemia symptoms) outweighs the documented gastrointestinal harms.We could not draw conclusions regarding erythropoietin treatment due to lack of evidence.Further research should evaluate treatment effect through clinical outcomes, i.e. presence and severity of anaemia symptoms balanced against harms, i.e. survival and severe morbidity.

show abstract

Intravenous iron sucrose versus oral iron ferrous sulfate for antenatal and postpartum iron deficiency anemia: a randomized trial

Abstract: Intravenous and oral irons were both effective in correcting peripartum anemia, although intravenous iron restored stores faster than oral iron.

Cited by 92 publications

References 18 publications

Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Risk of Infection Associated With Administration of Intravenous Iron

Treatment for women with postpartum iron deficiency anaemia

Contact Info

Product

Resources

About