Treatment of Iron Deficiency Anemia with Intravenous Iron Preparations

Abstract

Objective: We aimed to determine the effects of intravenous iron therapy on blood parameters in pediatric patients who do not tolerate oral iron therapy for any reason. Patients and Methods: The patient group consisted of candidates for elective operations requiring blood transfusions in order to raise hemoglobin (Hb) concentrations rapidly and for whom oral iron administration is useless and compliance with long-term treatment is definitely impossible due to sociocultural factors. Sixty-two children were included in the study. Venous blood samples were taken at diagnosis, and after 1 week and 1, 2 and 3 months. Hb, hematocrit, erythrocyte indices (mean erythrocyte volume, mean erythrocyte Hb and mean erythrocyte Hb concentration), serum iron (SI) levels, iron binding capacity, transferrin receptor (CD71) and serum ferritin levels were measured. Iron sucrose was used as an intravenous iron preparation. Results: All children showed improvements in iron deficiency anemia. A statistically significant elevation occurred between the time of diagnosis and week 1 (p<0.05) in nearly all parameters. SI was raised until at least 1 month of therapy. There was no significant difference between transferrin receptors measured before and after the intravenous iron therapy. Ferritin did not exceed the values achieved in the 1st month. Mild side effects were encountered in only 8 (12.9%) patients. Treatment was not discontinued because of side effects in any case. The patients in the control group were given an oral form containing ferroglycine sulfate. Conclusion: Intravenous iron therapy can replace oral therapy in patients whose blood parameters must be raised rapidly and in situations where oral iron administration would not be appropriate for any reason. However, reinforcement with oral iron therapy or additional intravenous doses would be appropriate.

Intravenous iron sucrose for children with iron deficiency anemia: a single institution study

“…[22] The experience with iron sucrose administration for children with IDA is very limited. Akarsu et al [7] evaluated its efficacy and safety in 62 children with IDA. The pretreatment level of hemoglobin rose from 7.9±1.2 g/dL to 11.4±1.1 g/dL three months after therapy.…”

“…[6] The experience with IV iron sucrose for the treatment of IDA in children is very limited, and all manufacturers do not recommend its use in children due to lack of adequate pediatric data. [7][8][9] We describe herein our department's experience with the use of IV iron sucrose in children with IDA that were intolerant, non-compliant or failed to respond to oral iron therapy.…”

Iron sucrose – characteristics, efficacy and regulatory aspects of an established treatment of iron deficiency and iron-deficiency anemia in a broad range of therapeutic areas

“…The study in 18-to 180-month-old children who were scheduled for elective surgery showed significant improvements in Hb from month 1 to the end of the 3-month study period [78]. Children in the control group who were treated with oral ferrous glycine sulfate (no details on dosing reported) achieved a similar Hb increase.…”

“…Two studies were performed in iron-deficient children and adolescents with low Hb levels [78,79] and treated with IS at individual doses of 6.5 --18.1 mg iron/kg and 5 mg/kg, respectively. The study in 18-to 180-month-old children who were scheduled for elective surgery showed significant improvements in Hb from month 1 to the end of the 3-month study period [78].…”

“…iron products). Among the 36 published clinical studies [45][46][47][48][49][50][55][56][57][58][59][60]64,65,70,74,[76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91] that are included in the clinical dossier of Venofer, 26 reported at least some details about adverse drug events; 3 of those reported at least possibly related serious adverse events (all nonfatal, Table 2) [51,76,77]. Three reports included only general statements on safety without further details (e.g., no serious adverse reactions were noted) [47,48,64].…”