Oral versus intravenous iron therapy in iron deficiency anemia: An observational study

Samarendra N Das; Amruta Devi; Bibhuti B Mohanta; Anurag Choudhury; Abinash Swain; Pravat K Thatoi

doi:10.4103/jfmpc.jfmpc_559_20

Oral versus intravenous iron therapy in iron deficiency anemia: An observational study

J Family Med Prim Care. 2020 Jul 30;9(7):3619-3622. doi: 10.4103/jfmpc.jfmpc_559_20. eCollection 2020 Jul.

Authors

Samarendra N Das¹, Amruta Devi², Bibhuti B Mohanta³, Anurag Choudhury⁴, Abinash Swain⁴, Pravat K Thatoi⁴

Affiliations

¹ Department of Medicine, PRM Medical College, Baripada, Odisha, India.
² Department of Nephrology, SCB Medical College, Cuttack, Odisha, India.
³ Department of Medicine, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
⁴ Department of Medicine, SCB Medical College, Cuttack, Odisha, India.

Abstract

Background: Intravenous (IV) iron sucrose is claimed to have better safety profile and efficacy in treatment of iron deficiency anemia than conventional oral iron supplements.

Aim: The aim of the study was to compare the efficacy and safety of IV iron therapy with oral iron supplements in iron deficiency anemia.

Methods: An observational study was carried out by allocating 100 patients with baseline hemoglobin between 5 and 10 g/dL into two groups of oral iron and IV iron group. Hemoglobin and serum ferritin levels were measured at admission, on day 14 and on day 28. Adverse effect profile for each group was tabulated. Mean and standard deviation were calculated for each group and compared.

Results: A total of 100 patients participated consisting of 37 males and 63 females. Baseline hemoglobin and serum ferritin for both groups were comparable. After initiation of therapy, hemoglobin in oral iron group raised from 6.45 (0.72) to 8.84 (0.47) on day 14 and to 9.69 (0.47) on day 28. Hemoglobin in IV iron group increased from 6.34 (0.86) to 10.52 (0.61) on day 14 and to 11.66 (0.84) on day 28. Serum ferritin in oral iron group increased from 8.3 (1.9) to 33.8 (1.29) on day 14 and to 43.61 (8.8) on day 28. Serum ferritin in IV iron group raised from 8.23 (4.64) to 148.23 (11.86) on day 14 but decreased to 115.76 (15.3) on day 28. The data were statistically significant for IV iron therapy on day 14 and day 28. Of 100 patients, 18 patients (12 in oral and 6 in IV iron groups) had adverse effects. Among the oral iron group, metallic taste and constipation were major side effects followed by heart burn and nausea. In the IV iron group, arthralgia (4 patients of 6) was the major side effect observed. One patient (of 6) in IV group had hypotension. Anaphylaxis was not observed in any patient in either group.

Conclusion: IV iron therapy is effective and safe for management of iron deficiency anemia.

Keywords: Iron deficiency anemia; intravenous iron sucrose; oral ferrous sulfate.