Sucrosomial® Iron: An Updated Review of Its Clinical Efficacy for the Treatment of Iron Deficiency

Abstract

Iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent worldwide. Oral iron salts, especially ferrous sulfate, are commonly used for the treatment of iron deficiency (ID). However, its use is associated with gastrointestinal side effects, thus compromising treatment compliance. Intravenous iron administration is a more costly and logistically complex alternative and is not risk-free, as infusion and hypersensitivity reactions may occur. Sucrosomial® iron is an oral formulation consisting of ferric pyrophosphate conveyed by a phospholipid and sucrester matrix (sucrosome®). Intestinal Sucrosomial® iron absorption is mediated by enterocytes and M cells, through the paracellular and transcellular routes, and occurs mostly as intact particles. These pharmacokinetic properties of Sucrosomial® iron result in higher iron intestinal absorption and excellent gastrointestinal tolerance compared to oral iron salts. The evidence derived from clinical studies supports the use of Sucrosomial® iron as a valid first option for the treatment of ID and IDA, especially for subjects who are intolerant or refractory to conventional iron salts. Newer evidence also demonstrates the effectiveness of Sucrosomial® iron, with a lower cost and fewer side effects, in certain conditions usually treated with IV iron in current clinical practice.

Predicting response to iron supplementation in patients with active inflammatory bowel disease (PRIme): a randomised trial protocol

“…21 In addition, newer oral iron formulations, such as ferric maltol or sucrosomial iron, have been postulated to be absorbed differently than standard iron salt compounds and have been associated with excellent therapeutic success likely due to improved enteral absorption that is less affected by hepcidin-a systemic iron regulator that modulates enteral iron absorption and systemic iron availability. [22][23][24][25][26] In contrast to standard iron salt compounds, iron from these newer formulations does not readily dissociate, resulting in lower levels of free luminal iron and, consequently, fewer side effects. 23 24 26 Nevertheless, oral iron therapy in active disease states remains controversial.…”

“…[22][23][24][25][26] In contrast to standard iron salt compounds, iron from these newer formulations does not readily dissociate, resulting in lower levels of free luminal iron and, consequently, fewer side effects. 23 24 26 Nevertheless, oral iron therapy in active disease states remains controversial. Murine studies showed that oral iron might exacerbate underlying disease due to excess enteral iron, which alters the intestinal microbiota and increases oxidative stress.…”

Use of Different Iron Preparations for Prophylaxis and Effects on Iron Status in Infancy

“…However, approximately 50% of those taking oral iron report gastrointestinal (GI) side effects, which can lead to decreased tolerance and reduced compliance with iron supplementation [24,25]. In recent years, iron preparations with different pharmacokinetics such as microencapsulated iron and sucrosomial iron have been used for ID [26,27]. These preparations are reported not to cause side effects such as GI irritation, often associated with iron salts.…”