Randomized clinical trial of IV iron sucrose and IV ferric carboxymaltose in the treatment of moderate iron deficiency anaemia in pregnancy

Abstract

In India, the national nutritional anaemia control programme (NNACP) was started in 1970 and is being implemented through primary health centers and sub centers. It recommended pregnant women to take one iron tablet per day for at least 100 days (each tablet containing 100 mg of natural iron and 500 mcg of folic acid) after first trimester of pregnancy; a similar dose applies to lactating women. Study Design: Randomized clinical trial. 160 pregnant ladies going to antenatal clinic at 14-36 weeks of gestation with Hb 7- 9.9g%. Who met the inclusion criteria were arbitrarily distributed into two groups. One with odd registration number was given iron sucrose and one with even was given FCM. Hematological profile includes Haemoglobin, Reticulocyte count, Blood indices (MCH, MCHC, MCV) Fringe smear, Serum iron and Serum TIBC. 52% cases from FCM group observed in the age gathering of 21-24 years and 39% cases from Iron Sucrose group were observed in the age gathering of 25-28 years. 54% cases from FCM and 46% cases from Iron sucrose were observed in the gestational Age of 29 to 36 weeks. 43% cases from FCM and 46% cases from Iron sucrose were primigravida. Patients from FCM group and 4 patients from Iron sucrose group did not follow up. 2 pts. From FCM group and 1 pt. from Iron sucrose group refused treatment. The rise in mean Hb level after 1 week and 4 weeks of treatment with FCM is more than Iron sucrose. The rise in mean Sr. Iron level after 1 week and after 4 weeks of treatment with FCM is more than Iron sucrose. The reduction in mean Sr. TIBC level after 4 weeks of treatment with Iron sucrose is more than FCM. The rise in mean MCH, MCHC and MCV levels after 1 week and 4 weeks of treatment with FCM is more than Iron sucrose. There was no serious adverse effect noted in both groups.

Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis

“…Additional analyses based on broad grouping of iron preparations (by route of administration and type of iron salt) found intravenous preparations compared best against no intervention (Appendix pp [39][40][41][42]. In a subgroup analysis by income category, the evidence on different results based on trials from low-middle income countries were similar to those presented in the analysis for haemoglobin (Appendix pp [50][51]. Network meta-analysis based on trials from high income countries was not performed due to the small number of studies in this subgroup (appendix p 52).…”

“…Of all included trials, 30 (62 arms; 3243 women) reported on haemoglobin at four weeks from baseline and were included in the network meta-analysis for haemoglobin. 14,17,34,39,50,51,53, Characteristics of studies contributing and not contributing data to the network meta-analysis are presented in Table 1.…”

Efficacy of ferric carboxymaltose for treatment of iron deficiency anemia diagnosed in the third trimester of pregnancy: A case–control study

“…18 Jose et al and Raiwani et al, observed that treatment with IV FCM resulted in a rapid replenishment of iron stores in pregnant women and was associated with a significantly higher Hb rise compared to IV iron sucrose. 26,27 Some limitations of our study deserve to be mentioned. First of all, included women, after an adequate counseling, chose the therapy based exclusively on their preference.…”

“…Breymann et al showed that IV FCM, compared to FS, was associated with a higher chance of anemia correction (OR: 2.06 [95% CI, 1.07–3.97]) and within a shorter time frame 18 . Jose et al and Raiwani et al, observed that treatment with IV FCM resulted in a rapid replenishment of iron stores in pregnant women and was associated with a significantly higher Hb rise compared to IV iron sucrose 26,27 …”