Comparative study of efficacy and safety of parenteral iron sucrose versus ferric carboxymaltose in treatment of postpartum iron deficiency anaemia

Authors

  • Ganesh N. Dakhle Department of Pharmacology, AIIMS, Nagpur, Maharashtra, India
  • Mrunalini V. Kalikar Department of Pharmacology, GMC, Nagpur, Maharashtra, India
  • Rujuta P. Fuke Department of Obstetrics and Gynaecology, GMC, Nagpur, Maharashtra, India
  • Anisha S. Parmarthi Department of Pharmacology, GMC, Nagpur, Maharashtra, India
  • Mrunalini K. Chokhandre Department of Pharmacology, GMC, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20215083

Keywords:

Ferric carboxymaltose, Iron sucrose, Postpartum iron deficiency anaemia

Abstract

Background: Postpartum anaemia often leads to multiple clinical complications in mother as well as infant and iron supplementation with parenteral iron is the preferred treatment modality. The present study was planned to compare the efficacy and tolerability of IV iron sucrose and IV ferric carboxymaltose in treatment of postpartum iron deficiency anaemia.

Methods: This randomized, parallel, open label, prospective 4-weeks study was conducted from June 2019 to December 2020 in women with postpartum anaemia admitted to obstetrics and gynaecology inpatient department of a tertiary care hospital. Women with postpartum iron deficiency anaemia (N=60) were randomly divided into two groups; receiving Injection iron sucrose (N=30, maximum dose 500 mg) or Injection ferric carboxymaltose (N=30, maximum dose 500 mg). Change in haemoglobin and serum ferritin levels from baseline to the end of 2 and 4 weeks of treatment were evaluated.

Results: The results showed early, sustained and significant increase in the haemoglobin levels in both the groups. However, the difference was not significant between groups (p=0.2). Evaluation of replenishment of iron stores (serum ferritin) showed improvement in both the groups, however in FCM group the rise was found to be significant (p<0.05).

Conclusions: FCM in a lower dose of 500mg was found to be safe and effective in significantly improving haemoglobin concentration as well as in replenishing iron stores in patients with postpartum anaemia.

References

Report of a WHO group of experts on nutritional anemias, technical report series 503. Available at: https://apps.who.int/iris/handle/10665/40977. Accessed on 20 September 2021.

Kouser S, Kouser S, Malik M, Malik A. Safety and efficacy of intravenous iron therapy in postnatal patients with iron def anaemia. J South Asian Fed Obstet Gynaecol. 2011;3:25-7.

Milman N. Postpartum anemia I: definition, prevalence, causesand consequences. Ann Haematol. 2011;90:1247-53.

National iron+initiative: guidelines for control of iron deficiency anaemia. Available at: https://www. nhm.gov.in/images/pdf/programmes/child-health/guidelines/Control-of-Iron-Deficiency-Anaemia.pdf. Accessed on 20 September 2021.

Bhagwan D, Kumar A, Rao CR, Kamath A. Prevalence of anaemia among postnatal mothers in coastal Karnataka. J Clin Diagnostic Res. 2016;10: LC17-20.

Noronha JA, Bhaduri A, Bhat VH, Kamath A. Maternal risk factors and anaemia in pregnancy: A prospective retrospective cohort study. J Obs Gynaecol. 2010;30:132-6.

Rathod S, Samal SK, Mahapatra PC. Ferric carboxymaltose: A revolution in the treatment of postpartum anemia in Indian women. Int J Appl Basic Med Res. 2015; 5(1):25-30.

Kaur K. Anaemia ‘A silent killer’ among women in India: Present scenario. Euro J Zool Res. 2014;3(1): 32-6.

Singh A, Yerragudi R. Comparative study of safety and efficacy of intravenous iron sucrose and ferric carboxymaltose in the treatment of postpartum iron deficiency anaemia. Int J Reprod Contracept Obstet Gynecol. 2016;5(4):1130-3.

Pena-Rosas JP, De-Regil LM, Garcia-Casal MN. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;7:Cd004736.

Nanjundan P. Comparison of various treatment modalities of iron deficiency anaemia in pregnancy. World J Aneamia. 2017;1(1):23-36.

Friedrischa JR, Cançadob RD. Intravenous ferric carboxymaltose for the treatment of iron deficiency anemia. Rev Bras Hematol Hemoter. 2015;37(6): 400-5.

Bailie GR. Efficacy and safety of ferric carboxymaltose in correcting iron-deficiency anemia: a review of randomized controlled trials across different indications. Arzneimittelforschung. 2010;60 (6a):386-98.

Ganzoni AM. Intravenous iron-dextran: therapeutic and experimental possibilities. Schweizerische Medizinische Wochenschrift. 1970;3(7):301-3.

Lunagariya M, Kanaklatta DN, Vithal A, Patel J, Patel M. Iron sucrose vs. ferric carboxymaltose: in search of better treatment option in cases of postpartum iron deficiency anemia. Int J Contemp Med Res. 2018;5(1):12-6.

Hol KV, Damle H, Shekhawat GS, Hol A. Comparative study of intravenous iron sucrose versus ferric carboxymaltose for the treatment of iron deficiency anemia in postpartum patients. Int J Reprod Contracept Obstet Gynecol. 2015;4:669-73.

Joshi SD, Chikkagowdra S, Kumar VCM. Comparative study of efficacy and safety of intravenous ferric carboxy maltose versus iron sucrose in treatment of postpartum iron deficiency anemia. Int J Reprod Contracept Obstet Gynecol. 2016;5:2566-70.

Recommendations on Postnatal Care of the Mother and Newborn. Available at: https://apps.who. int/iris/handle/10665/97603. Accessed on 20 September 2021.

Van Wyck DB, Martens MG, Seid MH, Baker JB, Mangione A. Intravenous ferric carboxymaltose compared with oral iron in the treatmentof postpartum anemia: A randomized controlled trial. Obstet Gynecol. 2007;110:267-78.

Aggarwal RS, Mishra VV, Panchal NA, Patel NH, Deshchougule VV, Jasani AF. Comparison of oral iron and IV iron sucrose for treatmentofanemia in postpartum Indian women. Natl J Comm Med. 2012; 3:48-54

Rathod S, Samal SK, Mahapatra PC, Samal S. Ferric carboxymaltose: a revolution in the treatment of postpartum anemia in Indian women. Int J App Basic Med Res. 2015;5(1):25.

Longo SA, Moore RC, Canzoneri BJ, Robichaux A. Gastrointestinal conditions during pregnancy. Clin Colon Rectal Surg. 2010;23(2):80-9.

Management of iron deficiency anemia in pregnancy. Available at: www.fogsi.org/wp-content/uploads/ 2017/gcprrecommendtion-ida.pdf. Accessed on august 2021.

Drugs safety data. Available at: https://www. accessdata.fda.gov/drugsatfda_docs/label/2018/203565s005lbl.pdf. Accessed on 20 August 2021

Sharma NJ, Thiek L, Natung T, Ahanthem SS. Comparative study of efficacy and safety of ferric carboxymaltose versus iron sucrose in post-partum anaemia. J Obstet Gynecol India. 2017:67(4):253-7.

Breymann C. Treatment of iron deficiency anemiain pregnancy and postpartum. In: Studd J, Tan SL, Chervenak FA, eds. Current Progress in Obstetrics and Gynaecology, 1st ed. Mumbai: Tree Life Media; 2012:135-48.

Downloads

Published

2021-12-28

Issue

Section

Original Research Articles