scholarly journals Experience of a Single Latin-American Institution Using a Colloidal Iron Oxide Coated with a Semisynthetic Carbohydrate (ferumoxytol) for Iron Deficiency Anemia (IDA) in Patients with Intolerance or Treatment Failure with Oral Iron

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4887-4887
Author(s):  
Roberto Ovilla ◽  
Dannia Calles-Payan ◽  
Lucia A Reynolds-Ocampo ◽  
Gabriela Ruiz-Reyes ◽  
Carolina Balderas-Delgado ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Adverse Effects ◽  
Iron Deficiency Anemia ◽  
Latin American ◽  
Transferrin Saturation ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Number Of Patients ◽  
Initial Symptoms ◽  
The Mean

Abstract Tolerance to oral iron and low percentage of absorption in the gut has provoked the Iron Deficiency Anemia patients (IDA) fail to treatment or they have symptoms of anemia even more than 12 weeks until recovery. Intravenous iron is an alternative to minimize risk and treatment-related adverse effects and maximize profits in the short and long term. The number of patients who have access to ferumoxytol is reduced in developing countries, therefore experience in the treatment with this type of iron is limited. Patients received ferumoxytol 1020mg (two 510mg 8 days apart) and the response at 4 weeks of treatment by raising hemoglobin and clinical response was evaluated without transfusion support. From a total of 30 patients 76.6% (19) were women of whom 36.8% (7) were postmenopausal. The average age was 45.3 years (range 21-76 years). Before starting treatment, the mean serum iron, ferritin and rate of transferrin saturation was 35.6 mcg (range 8–174 mcg/dL), 13.8 ng/mL (range 1.6–60 ng/mL), 10.8% (range 2-58%) respectively. The mean initial hemoglobin was 10.5 g / dL (range 7.1-13.7g/dL), reaching an average of 13.03 g dL (range 9.4 - 16 _g/dL) at 4 weeks, raising 2.52 g dL (0.3 - 5.4g / _ g/dL) in 28 days. The percentage of patients who achieved an increase of > 2 g/dL of hemoglobin was 70% (21). The initial symptoms attributed to anemia disappeared in 66.6% within the first 2 weeks and the rest in 4-5 weeks. Adverse effects more frequently than 2%: fatigue 16.6% (5), headache 10% (3), nausea and dizziness 10% (3), peripheral edema 6.6% (2) and hypersensitivity 3.3% (1). All previous were easily controlled with medications. Despite the low number of patients treated due to the difficult accessibility of the drug in our population, ferumoxytol was shown to be an attractive option that rapidly improves symptoms with a satisfactory safety profile. Disclosures No relevant conflicts of interest to declare.

scholarly journals Plasma and Erythrocyte Folate in Iron Deficiency and Folate Deficiency

Blood ◽  
1970 ◽  
Vol 35 (6) ◽  
pp. 821-828 ◽  
Author(s):  
A. OMER ◽  
N. D. C. FINLAYSON ◽  
D. J. C. SHEARMAN ◽  
R. R. SAMSON ◽  
R. H. GIRDWOOD
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Megaloblastic Anemia ◽  
Folate Deficiency ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Plasma Folate ◽  
Erythrocyte Folate ◽  
The Mean ◽  
Anemia Group

Abstract Erythrocyte and plasma folate levels were studied before treatment in 20 patients with iron deficiency anemia and in 23 patients with megaloblastic anemia due to folate deficiency. Fourteen of the cases of iron deficiency anemia were also studied after treatment with oral iron alone. Fifty-seven normal persons were used as controls. The mean erythrocyte folate (ng./ml. packed cells) was significantly increased in iron deficiency anemia and significantly depressed in folate deficiency anemia. After treatment with oral iron alone, the mean erythrocyte folate level fell to normal in the iron deficiency anemia group. The mean corpuscular folate (ng. x 108-8) was also significantly raised in iron deficiency: in eight of 10 cases this fell after treatment, but the overall fall was not significant. The plasma folate rose in iron deficiency anemia after oral iron treatment.

scholarly journals Efficacy and safety of high dose accelerated intravenous iron sucrose in patients of iron deficiency anemia

2017 ◽  
Vol 5 (8) ◽  
pp. 3359
Author(s):  
Muzafar Naik ◽  
Tariq Bhat ◽  
Ummer Jalalie ◽  
Arif Bhat ◽  
Mir Waseem ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
High Dose ◽  
Oral Iron Therapy ◽  
The Mean

Background: Low dose (200 mg) extended Intravenous iron sucrose remains the most common treatment option in patients who are intolerant to oral iron therapy in patients with Iron deficiency anemia (IDA). The objective of this study was to evaluate the efficacy and safety of high dose accelerated intravenous iron sucrose (IS) in the treatment of adults with iron deficiency anemiaMethods: One hundred adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received daily doses of 500 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient.Results: The mean and median Hb (g/dL) 6.47±1.656 and 6.6 (2) at baseline, 9.61±1.629 and 9.6 (2) at 2 weeks of treatment, 11.85±1.277 and 12 (1) at 4 weeks of treatment respectively. The mean rise of Hb was 3.13±1.41 and 5.37±1.50 after 2 and 4 weeks of treatment respectively (p<0.000). A total of 303 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with twenty-six patients developing mild and one patient developing moderate adverse drug reactions. There was no serious adverse event recorded.Conclusions: Accelerated high dose intravenous iron sucrose is a safe and cost effective option minimizing frequent hospital visits in the treatment of adults with iron deficiency anemia who are intolerant or lack satisfactory response to oral iron therapy.

Hepcidin Levels Predict Non-Responsiveness to Oral Iron Therapy in Patients with Iron Deficiency Anemia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 484-484
Author(s):  
Lawrence T. Goodnough ◽  
David Morris ◽  
Todd Koch ◽  
Andy He ◽  
David Bregman
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Predictive Values ◽  
Oral Iron Therapy

Abstract Abstract 484 Background Treatment options for individuals diagnosed with iron deficiency anemia (IDA) include oral or intravenous iron. Oral iron may not increase patient hemoglobin levels adequately, due to poor compliance and/or suboptimal gastrointestinal absorption due to inflammation-mediated induction of hepcidin, which regulates iron homeostasis. This study evaluated whether hepcidin levels can be used to identify patients with IDA who are unresponsive to oral iron therapy. Methods Hepcidin levels were assessed in a subset of subjects enrolled in a randomized trial comparing oral iron (ferrous sulfate) to intravenous iron (Injectafer®[ferric carboxymaltose, FCM]) in subjects with IDA (Hemoglobin [Hb] ≤ 11 g/dL; and ferritin ≤ 100 ng/mL, or ≤ 300 ng/mL when transferrin saturation (TSAT) was ≤ 30%) (Szczech et al Amer Soc Nephrol 2011; 22:405A). Subjects who met the inclusion criteria underwent a 14-day (run-in) course of ferrous sulfate 325 mg, three times per day. Subjects with an increase in Hb ≥ 1 g/dL were considered to be “responders” and not randomized. “Non-responders” were randomized to ferric carboxymaltose (2 injections of 750 mg given on Day 0 [day of randomization] and Day 7) or oral iron for 14 more days. Hb levels and markers of iron status were assessed at screening (day-15), day-1 and day 35. Hepcidin levels were analyzed at screening (Day -15) in an initial Cohort (I) of 44 patients, 22 responders and 22 non-responders. A hepcidin value of >20 ng/mL was identified for further analysis for predictive values for non-responsiveness to 14 day oral iron run-in in 240 patients (Cohort II). Hepcidin levels were also analyzed at Day -1 and Day 35 in a Cohort (III) of patients who were then randomized to FCM vs. oral iron therapy. Results Hepcidin screening levels in Cohort I were significantly higher in the non-responders vs. responders (33.2 vs. 8.7 ng/mL, p < 0.004). Twenty one of 22 non-responders had hepcidin values > 20 ng/mL. For Cohort II, mean hepcidin levels were again significantly higher in the non-responders vs. responders (38.4 vs. 11.3 ng/mL, p = 0.0002). Utilizing a hepcidin criterion of > 20 ng/mL, we found a sensitivity of 41.3% (26 of 150), specificity of 84.4% (76 of 90), and a positive predictive value (PPV) of 81.6% (62 of 76) for non-responsiveness to oral iron (Figure: The Receiver Operator Characteristic curves present plots of sensitivity vs. (1-specificity) for hepcidin, ferritin, and TSAT at the various cutoff levels indicated near the respective curves in the same color as the respective curves). While ferritin < 30ng/mL or TSAT <15% had greater sensitivity (77.3% and 64.7%, respectively), their PPVs (59.2% and 55%) were inferior to PPVs for hepcidin. Patients subsequently randomized to FCM vs. oral iron responded with Hgb increases of ≥1 g/dL for 65.3% vs. 20.8% (p <0.0001)and mean Hgb increases of 1.7 ± 1.3 vs. 0.6 ± 0.9 g/dL (p = 0.0025), respectively. Conclusion Our analysis provides evidence that non-responsiveness to oral iron in patients with iron deficiency anemia can be predicted from patients' baseline hepcidin levels, which have superior positive predictive values compared to transferrin saturation or ferritin levels. Furthermore, non-response to oral iron therapy does not rule out iron deficiency, since two thirds of these non-responders to oral iron responded to IV iron. Disclosures: Goodnough: Luitpold: Consultancy. Off Label Use: ferric carboxymaltose for treatment of iron deficiency anemia. Morris:Luitpold: Consultancy. Koch:Luitpold: Employment. He:Luitpold: Employment. Bregman:Luitpold: Employment.

scholarly journals CORRELATION BETWEEN MEAN PLATELET VOLUME AND IRON DEFICIENCY ANEMIA

2019 ◽  
Vol 8 (4) ◽  
Author(s):  
Himanshu Dagor
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Peripheral Blood ◽  
Mean Platelet Volume ◽  
Ferritin Level ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Platelet Volume ◽  
Iron Treatment ◽  
The Mean

Background: Iron inhibits megakaryopoiesis so iron deficiency anemia (IDA) leads to microthrombosis. Iron therapy ameliorates thrombocytosis. In this study, we investigated whether young, active, and large platelets are released into peripheral blood during iron treatment. Mean platelet volume (MPV) was measured as an indicator for the presence of these platelets. Materials and Methods: A total of 80 patients (10 males and 70 females) with IDA were included in this retrospective study. IDA was defined as ferritin level <50 ng/mL with a transferrin saturation <20% or ferritin <15 ng/mL. Daily ferrous sulfate (270 mg iron II sulfate and    80 mg of elemental iron) was given orally to patients. We evaluated retrospectively the hematologic and biochemical parameters prior to and 1 month after iron treatment. Results: the mean ferritin level of the pretreatment group was 6.5 ± 4.0 ng/mL, MPV was 7.9 ± 1.5 fL, hemoglobin (Hb) was 9.8 ± 1.5 g/dL and the mean cellular volume (MCV) was 71.2 ± 7.2 fL. The mean ferritin level of the posttreatment group was 40.3 ± 15.2 ng/mL, MPV was 8.6 ± 2.0 fL, Hb was 12.5 ± 6.6 g/dL, and MCV was 77.6 ± 5.4 fL. The levels of ferritin (P < 0.001), MPV (P < 0.001), MCV (P < 0.001), and Hb (P < 0.001) were significantly higher in the posttreatment group compared to the pretreatment group. Conclusion: There may be an increase in thrombotic events due to hypercoagulability related to microthrombosis during IDA. Even though thrombosis is corrected during iron treatment, the therapy increases the release of large and active thrombocytes into the peripheral blood. Keywords: Iron, iron deficiency anemia, mean platelet volume, thrombocytosis, thrombosis

scholarly journals The overbearing physiological changes marring iron indices interpretation in response to iron therapy during pregnancy

2021 ◽  
Vol 18 (3) ◽  
pp. 39-42
Author(s):  
Chandrika N ◽  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Biochemical Parameters ◽  
Serum Iron ◽  
Transferrin Saturation ◽  
Oral Iron ◽  
Response To Therapy ◽  
Iron Therapy ◽  
Deficiency Anemia

Background: Iron deficiency anemia (IDA) is most common cause of anemia in pregnancy. In order to prevent this iron supplementation is routinely practiced as a prophylactic measure in pregnant women all over. The biochemical parameters assessed in IDA comprise an iron profile evaluation which consists of estimation of serum ferritin, serum iron, total iron binding capacity(TIBC), serum transferrin levels and calculation of transferrin saturation. These biochemical parameters are subjected to variations due to maternal adaption phenomenon. Aim: In the current study we have chosen three iron indices, serum iron, serum TIBC and transferrin saturation percent to note their performance in diagnosing and monitoring the response to iron therapy in pregnant women. Methodology: The study population are thirty- six pregnant women in their early second trimester, who are diagnosed with mild iron deficiency anemia (Hemoglobin between 9 and 11 g %). Iron parameters, serum iron, serum TIBC and transferrin saturation levels were analyzed in these women. They are then given oral iron preparation in the form of Ferrous sulphate for a period of twelve weeks. After this the Hemoglobin level, serum iron, TIBC and transferrin saturation levels are re-analyzed in these women. Results: The hemoglobin levels increased (p= 0.002). as expected after oral iron intake. Serum iron levels improved from 58.19±39.07 to 64.78±34.96 μg/dl. Serum TIBC value before supplementation 234.22±134.49 increased to 437.33±94.95 after, which contradicts the expected pattern seen in response to therapy in general population. Similarly absurdity prevails in transferrin saturation index levels which dropped from 36.8 ± 31.8 to 16.3 ± 10.6. Conclusion: The iron status during pregnancy is highly influenced by the maternal changes. And a blind interpretation of the report can lead to erroneous diagnosis. The interpretation of values should be based on the trimester specific reference ranges during pregnancy.

scholarly journals The effect of nutrition education based on PRECEDE model on iron deficiency anemia among female students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Khani Jeihooni ◽  
Sanaz Hoshyar ◽  
Pooyan Afzali Harsini ◽  
Tayebeh Rakhshani
Keyword(s):  
Iron Deficiency ◽  
Nutrition Education ◽  
Blood Level ◽  
Iron Deficiency Anemia ◽  
Female Students ◽  
Deficiency Anemia ◽  
Fars Province ◽  
Significant Difference ◽  
The Mean ◽  
Experimental Group

Abstract Background Iron deficiency anemia disrupts the concentration of adolescent girls; reduces their academic achievement, productivity, and physical strength, and increases the risk of infection. This research aim was to evaluate the effectiveness of the PRECEDE model nutrition education on iron deficiency anemia among female students of Fasa City, Fars Province, Iran. Methods This quasi-experimental study was done on 160 students (80 experimental and 80 control groups) who were selected using a random sampling method in Fasa City, Fars Province, Iran, in 2018–2019. The educational intervention included six sessions based PRECEDE model for 45 or 50 min. A scale of this study consisted of two parts; demographic information, and PRECEDE constructs were used to determine the nutritional behaviors status concluding preventing iron deficiency anemia and hemoglobin, hematocrit, and ferritin blood level in two (before and 4 months after intervention) times. Results In the experimental group of the students the mean age was 13.85 + 1.72 years and in the controlled group was 13.60 + 1.81 years. Moreover, there was no significant difference in the PRECEDE constructs, and nutritional behaviors preventing iron deficiency anemia before the intervention in two groups of study. However, the experimental group showed a significant increase 4 months after the intervention. Also, there was no significant difference in the mean score of hemoglobin, hematocrit, and ferritin blood level between the two groups before the intervention. However, in ferritin level, a significant increase was shown in 4 months after the intervention in the experiential group. Conclusions Based on results, the nutrition intervention education base on PRECEDE model has a positive effect to improve iron deficiency anemia preventive behaviors in female students.

scholarly journals IRON ABSORPTION AND RESPONSE TO ORAL IRON THERAPY IN IRON DEFICIENCY ANEMIA ASSOCIATED TO ASYMPTOMATIC GIARDIASIS.

1993 ◽  
Vol 33 (6) ◽  
pp. 661-661
Author(s):  
Helena U Suzuki ◽  
Mauro B Morais ◽  
Jose N Corral ◽  
Ulisses Fagundes-Neto ◽  
Nelson L Machado
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Oral Iron Therapy

The Treatment of Iron-deficiency Anemia—Palatable but Ineffective Iron Medication

PEDIATRICS ◽  
1963 ◽  
Vol 31 (6) ◽  
pp. 1041-1044
Author(s):  
LOUIS K DIAMOND ◽  
J. LAWRENCE NAIMAN ◽  
DONALD M. ALLEN ◽  
FRANK A. OSKI,
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Ferrous Sulfate ◽  
Oral Iron ◽  
Gastrointestinal Absorption ◽  
Deficiency Anemia ◽  
Therapeutic Effects ◽  
Rapid Rise ◽  
Carbohydrate Complex ◽  
Therapeutic Results

Experience with a new oral iron-carbohydrate complex (Jefron) in the treatment of iron-deficiency anemia shows that the therapeutic results are inferior to those obtainable with ferrous sulfate. Many children showed no response after months of treatment with this drug and when subsequently placed on ferrous sulfate therapy showed a rapid rise in hemoglobin to normal levels. Preliminary studies suggest that poor gastrointestinal absorption may be a factor in the inadequate therapeutic effects.

Intravenous versus Oral iron for Iron-Deficiency Anemia in Pregnancy (IVIDA): A Randomized Controlled Trial

2021 ◽  
Author(s):  
Adam K. Lewkowitz ◽  
Molly J. Stout ◽  
Emily Cooke ◽  
Seon C. Deoni ◽  
Viren D'Sa ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Randomized Controlled ◽  
Iv Iron ◽  
Severe Adverse Reactions

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points

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