Assessment of the Efficacy and Safety of Intravenous Iron Sucrose in Treatment of Adult Patients with Iron Deficiency Anemia

Fadhil Alwan, Alaa

	Assessment of the Efficacy and Safety of Intravenous Iron Sucrose in Treatment of Adult Patients with Iron Deficiency Anemia
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 26, Issue 3, 2013, Pages 243-246
Author
Alaa Fadhil Alwan
Abstract
Abstract Background: Iron deficiency is the most common cause of anemia worldwide. The treatment for iron deficiency anemia consists of replacement of iron either orally or parenterally. Patients with iron deficiency anemia (IDA) who need intravenous iron are normally treated with iron dextran. One of the major side effects of iron dextran is severe (sometimes fatal) anaphylactic reaction. On the other hand, iron sucrose another intravenous iron preparation that has improved safety and ease of administration. This preparation is being used in dialysis patients with very good results. But this has never been formally evaluated in non-dialysis-dependent patients. Objective: To assess the efficacy and safety of intravenous iron sucrose in treatment of adult patients with iron deficiency anemia. Patients & Methods: Between August 2009 and August 2011, one hundred fifty eight patients with iron deficiency anemia who were seen at the out-patient clinic at the national center of hematology with hemoglobin level < 11 g/d, or inadequate response to iron oral therapy were included in this study. Written informed consent was obtained from all patients. The main laboratory tests done were: complete blood count and blood film, reticulocyte count, serum iron, total iron-binding capacity, serum ferritin. After testing dose, patients received a weekly dose of iron sucrose diluted in 500 mL of 0.9% sodium chloride solution administered intravenously for 3 to 4 hour. The dose was calculated according to special formula. Treatment continued until a hemoglobin level equal or more than 12 g/dL for women and 13 g/dL for men or until full administration of the total dose of parenteral iron recommended for each patient. Results: Mean age of the patients studied was 33 years (ages ranging from 17 to 66 years). One hundred thirty nine patients (88%) were females while 19 patients (12%) were males. The most common cause of iron deficiency anemia was abnormal uterine bleeding observed in 68% of the female patients (95 out of 139) and gastrointestinal causes observed in 63% of the male patients (12 out of 19). Correction of anemia was obtained in 144 out of 158 patients (91%). The mean hemoglobin and ferritin values were 8.09 g/dl and 6.20 ng/ml (before treatment) and 12.42 g/dl and 88.78 ng/ml (after treatment) (p < 0.001), respectively. In general the average increase of hemoglobin was 3.74 g/dl, ranging from 1.30 to 7.60 g/dl. . Among all the patients studied, only 8 patients (5%) had mild reactions related to intravenous iron. Conclusion: The use of intravenous iron sucrose is an effective and safe option in the treatment of adult patients with iron deficiency anemia lacking satisfactory response to oral iron therapy. This treatment option should be considered mainly for patients with severe anemia in order to obtain rapid increase of the hemoglobin level and avoid blood transfusion. Keywords: Efficacy, iron sucrose, iron deficiency anemia
Keywords
Efficacy; iron sucrose; Iron deficiency anemia

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