Monitoring oral iron therapy in children with iron deficiency anemia: an observational, prospective, multicenter study of AIEOP patients (Associazione Italiana Emato-Oncologia Pediatrica)

Russo, Giovanna; Guardabasso, Vincenzo; Romano, Francesca; Cortí, Paola; Samperi, Piera; Condorelli, Angelo Giuseppe; Sainati, Laura; Maruzzi, Matteo; Facchini, Elena; Fasoli, Silvia; Giona, Fiorina; Caselli, Desireé; Pizzato, Cristina; Marinoni, Maddalena; Boscarol, Gianluca; Bertoni, Elisa; Casciana, Maria Luisa; Tucci, Fábio C.; Capolsini, Ilaria; Notarangelo, Lucia Dora; Giordano, Paola; Ramenghi, Ugo; Colombatti, Raffaella

doi:10.1007/s00277-020-03906-w

Cited by 33 publications

(31 citation statements)

References 34 publications

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“… 76 Regarding liposomal (sucrosomial) iron, a multicenter study of the Associazione Italiana Emato-Oncologia Pediatrica documented its excellent tolerance, i.e., the complete absence of gastrointestinal side effects, but the limited number of patients with mild IDA treated limits the conclusions that can be drawn regarding the clinical efficacy of this formulation in children. 77 …”

Section: Treatment Of Ida With Oral Iron Productsmentioning

confidence: 99%

Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy

Mantadakis

Chatzimichael

Zikidou

2020

Mediterr J Hematol Infect Dis

111

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Iron deficiency and iron deficiency anemia (IDA) affect approximately two billion people worldwide and most of them reside in low- and middle-income countries. In these countries, additional causes of anemia include parasitic infections like malaria, other nutritional deficiencies, chronic diseases, hemoglobinopathies and lead poisoning. Maternal anemia in resource-poor nations is associated with low birth weight, increased perinatal mortality and decreased work productivity. Maintaining a normal iron balance in these settings is challenging, as iron-rich foods with good bioavailability are of animal origin that are expensive and/or available in short supply. Apart from infrequent consumption of meat, inadequate vitamin C intake and diets rich in inhibitors of iron absorption are additional important risk factors for IDA in low-income countries. In-home iron fortification of complementary foods with micronutrient powders has been shown to effectively reduce the risk of iron deficiency and IDA in infants and young children in developing countries but is associated with unfavorable changes in gut flora and induction of intestinal inflammation that may lead to diarrhea and hospitalization. In developed countries, iron deficiency is the only frequent micronutrient deficiency. In the industrialized world, IDA is more common in infants beyond the sixth month of life, in adolescent females with heavy menstrual bleeding, in women of childbearing age and elderly people. Other special at-risk populations for IDA in developed countries are regular blood donors, endurance athletes and vegetarians. Several medicinal ferrous or ferric oral iron products exist, and their use is not apparently associated with harmful effects on the overall incidence of infectious illnesses in sideropenic and/or anemic subjects. Further research is needed to clarify the risks and benefits of supplemental iron for children exposed to parasitic infections in the third world, and for children genetically predisposed to iron overload.

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Section: Treatment Of Ida With Oral Iron Productsmentioning

confidence: 99%

Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy

Mantadakis

Chatzimichael

Zikidou

2020

Mediterr J Hematol Infect Dis

111

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“…Our results were in accordance with that of Russo et al, who stated that after the second year of life the iron requirement rapidly increases, and diet becomes a critical issue. 9 OFS is the most prescribed drug for treating ID; however, it has been associated with 25 to 40% incidence of ADRs. Moreover, it has a variable bioavailability, thus stressing a need for better oral formulations.…”

Section: Discussionmentioning

confidence: 99%

Lactoferrin Efficacy versus Ferrous Sulfate in Treatment of Children with Iron Deficiency Anemia

El-Asheer

Ahmed

Hafez

et al. 2021

Journal of Child Science

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Lactoferrin (LF) is an iron-binding globular glycoprotein that is structurally and chemically similar to serum transferrin. Many studies have been done to evaluate the effect of oral LF administration on iron deficiency anemia (IDA) with controversial results. This study was designed to compare the efficacy of LF versus oral ferrous sulfate (OFS) therapy in the treatment of children with IDA. A significant increase in mean hemoglobin and serum iron concentrations was noted in the group that received oral bovine LF (11.06 ± 0.96 and 42.79 ± 6.14, respectively) versus the group that received OFS (10.24 ± 0.57 and 28.94 ± 5.05, respectively, with p < 0.001 for each) after 30 days of the treatment with fewer side effects (9.3 vs. 33.3% with p = 0.043). Oral bovine LF is a more effective and safer alternative in treating iron deficiency and IDA compared with OFS with clinical benefits of fewer side effects and better patient compliance.

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“…As for any deficiency, the management of iron deficiency proceeds in a series of essential steps, namely diagnosis using recommended biological markers and a follow-up of these markers during treatment. Although the efficacy of oral iron administration has been known for a long time, still there are many uncertainties on the better type of iron, on the dose 31 . Our study showed that in France, only a third of patients receiving iron replacement therapy had a specific pre-treatment biological assessment, and a biological assessment followed only one-seventh of all episodes.…”

Section: Discussionmentioning

confidence: 99%

Iron deficiency markers in patients undergoing iron replacement therapy: a 9-year retrospective real-world evidence study using healthcare databases

Cacoub

Nicolas

Peoc’h

2020

Sci Rep

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The diagnosis and treatment of iron deficiency is a primary public health goal. This study aimed to make an inventory of the use of biomarkers to assess the iron supply in patients given iron replacement therapy. A retrospective longitudinal real-world study of a cohort of patients receiving iron replacement therapy was conducted using data from healthcare coverage databases between January 2006 and December 2015 in France. The frequency of oral or intravenous iron treatment episodes preceded and/or followed by a biological assessment of iron deficiency was described. We then differentiate patients with or without chronic inflammatory diseases, which could impact the prescription. The evolution between 2006 and 2015 was also studied. The 96,724 patients received an average of 4.9 administrations of iron per patient, corresponding to 1.7 treatment episodes. In one-third of treatment episodes (34.6%), patients had a pre-treatment biological assessment, 15.5% a post-treatment assessment, and 7.3% both. The post-treatment measure of iron supply markers (i.e., Ferritin and transferrin saturation) was more frequent in patients suffering from chronic inflammatory diseases than in those without underlying chronic condition (22.6% to 41.0% vs. 3.1%; p < 0.0001). Serum ferritin was measured 30 times more than transferrin saturation measurements. The use of both tests increased steadily during the study period, although remaining low. Despite the recommendations, biological assessments of iron status are seldom prescribed and/or performed in the context of a pre- or post-treatment assessment, although more frequently realized in patients with chronic inflammatory diseases.

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Monitoring oral iron therapy in children with iron deficiency anemia: an observational, prospective, multicenter study of AIEOP patients (Associazione Italiana Emato-Oncologia Pediatrica)

Cited by 33 publications

References 34 publications

Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy

Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy

Lactoferrin Efficacy versus Ferrous Sulfate in Treatment of Children with Iron Deficiency Anemia

Iron deficiency markers in patients undergoing iron replacement therapy: a 9-year retrospective real-world evidence study using healthcare databases

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