ABSTRACT
Background: Anaemia has significant impact on health of the fetus as well as that of mother. Increased need of iron during pregnancy especially after 2nd trimester makes iron supplementation mandatory. Ferrous ascorbate is known to exist intact inside the gastrointestinal tract due to the stable chelation of iron with ascorbate. This compound does not dissociate due to any of the food inhibitors. The aim is to study the effec-tiveness of Ferrous Ascorbate and Ferrous sulphate in terms of compliance and cost effectiveness of manage-ment of anaemia in pregnancy. Methodology: Study design: Quasi Experimental study, Study area: District Vidisha, Study participants: Preg-nant women of first trimester registered during the study period in the selected Anganwadis/ Gram Arogya Kendra (GAK), Sample size: 240 antenatal mothers. Results: Baseline mean haemoglobin was 11.31±1.05 gm/dl. The mean increase in Ferrous Sulphate was 0.55 gm/dl, and in Ferrous ascorbate was 1.27 gm/dl. Ferrous Sulphate was less compliant than Ferrous ascorbate, and has higher efficacy and lesser side effects. Only Rs. 10.2 additional cost per antenatal mothers for increase of ≥1gm% in Hb will be borne by government if Ferrous Sulphate is replaced by Ferrous Ascorbate. Conclusions: Study results show statistically significant difference in rise of haemoglobin amongst the ante-natal mothers consuming Ferrous ascorbate over Ferrous Sulphate
ABSTRACT
Background: Iron deficiency anemia is the most common form of anemia and nutritional disorder worldwide. Oral iron therapy and blood transfusion has many drawbacks like noncompliance and risk of transmittable infections and transfusion reaction. The modern alternative therapy is treatment with intravenous iron. Present study compares the efficacy, safety and tolerability between intravenous iron sucrose and oral iron in iron deficiency anemia during 20-36 weeks of pregnancy.Methods: It was a randomized controlled study between December 2017 to September 2019. 200 patients attending antenatal OPD in Al Ameen Medical College, with haemoglobin levels between 7-9.9 gm/dl and serum ferritin of <15 ng/ml were enrolled. In intravenous group, 200 mg iron sucrose in 100ml normal saline was infused alternate day till the required dose was met. The oral group received 200 mg of oral iron ascorbate along with folic acid 1.5 mg per day for 6 weeks. Treatment efficacy was assessed by Hb and serum ferritin after 3 and 6 weeks.Results: Out of 200 patients, an increase in Hb was observed in both groups, rising from 9.7 g/dl to 10.3 g/dl and 10.9 g/dl after 3 weeks and 6 weeks respectively in oral group and from 8.6 g/dl to 9.8 g/dl and 10.8 g/dl after 3 weeks and 6 weeks respectively in intravenous group. Similar results were seen in ferritin levels. Rise in Hb and ferritin levels were greater in intravenous group than in oral group.Conclusions: Intravenous iron sucrose appears to be a better treatment option in comparison with oral iron, without serious side effects, better compliance and improved efficacy in correction of anaemia of pregnancy.
ABSTRACT
Background: Anaemia is a global health concern, associated with increased maternal and perinatal mortality, preterm delivery, low birth weight, extreme fatigue and impaired immune system; and controlled by oral haematinics; with a rise in haemoglobin concentration. The objective was to examine the various aspects of pharmacoepidemiology and pharmacohaemovigilance of oral haematinics, among the anaemic women population, in rural India.Methods: This was a multi-centre, retrospective, observational and analytical study of the hospital medical records of 250 anaemic patients, who were allocated into group A of 125 patients within 15-21 years and group B of 125 patients within 22-35 years. The patients were prescribed oral haematinics, containing 60 mg of elemental iron, thrice daily, with meals. The various aspects of pharmacoepidemiology and pharmacohaemovigilance of ferrous ascorbate, ferrous sulphate, ferrous fumarate and ferric ammonium citrate, including patients’ demographic characteristics, anaemic symptoms assessment, prescription patterns, and safety assessment, on 1st, 2nd, 3rd months and follow-up visits, were recorded and thoroughly analysed..Results: In groups A and B, the demographic characteristics of the patients were comparable; ferrous ascorbate was the most commonly prescribed oral haematinic, followed by ferrous sulphate, ferrous fumarate and ferric ammonium citrate, which controlled mild to moderate iron deficiency anaemia, with a gradual significant rise in haemoglobin concentration, in the successive 3 months; and adverse effects were observed to be statistically non-significant in either group.Conclusions: The different aspects of pharmacoepidemiology and pharmacohaemovigilance in the study established that the oral haematinics were reasonably beneficial and safe among the anaemic women population, in rural India.
ABSTRACT
Background: The post-partum period is challenging enough for most new mothers. Recovering from birth, learning to parent, and taking care of her child requires lot of energy. Having anemia in postpartum period can make this process much more difficult. According to WHO, in India incidence of anemia in postnatal mother is around 58% and according to ICMR prevalence of anemia in Tamil Nadu population 76% during pregnancy. The objective of this study was to compare the efficacy of intravenous iron supplementation with Iron sucrose to the oral supplementation with ferrous ascorbate in management of patient with post-partum anemia. To study the safety and side effects of these two preparations.Methods: This was a prospective study conducted on 100 post-partum anemic women in KG Hospital in Coimbatore, October 2012 to November 2013 with hemoglobin less than 10g/dl but more than 6g/dl within 24-48 hours of delivery ,after satisfying inclusion and exclusion criteria were included in the study.Results: Mean hemoglobin of oral group was 8.49±0.75 and mean hemoglobin of IV group was 8.43±0.76; 24 hours after delivery. After treatment, that is after 4 weeks mean hemoglobin of oral group was 10.38±0.79 and mean hemoglobin of IV group was 11.20±0.71.on comparing both groups, the increase in hemoglobin in the IV groups was significant. Reticulocyte count and other parameters increased significantly after four wks of starting therapy in IV group compare to the oral group. No major side effects or anaphylactic reactions were noted during study period.Conclusions: Intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with the oral ferrous ascorbate. Intravenous iron sucrose have shorter treatment periods, increased likelihood of compliance, a lack of gastrointestinal side effects, and rapid replenishment of iron stores, making them superior to oral ferrous ascorbate.
ABSTRACT
Background: Anemia due to Iron deficiency is the commonest malnutrition disorder seen throughout the world and in India. It is also responsible for increased incidence of premature births, low birth weight babies and high perinatal mortality. Hence, the present study undertaken to assess efficacy and safety of injectable iron sucrose with oral ferrous ascorbate.Methods: 100 pregnant women, between gestational age 14 and 28 weeks were divided randomly into two groups i.e. group A consists of oral iron, a total of 200 mg of elemental iron per day, two 100mg iron tablets per day and group B consists of iron sucrose at the rate of 200mg on alternate OPD day. Informed consent was taken from each patient.Results: The percentage rise in hemoglobin at fourth and eighth weeks of treatment was statistically significant when compared to the baseline. Statistically significant rise in hemoglobin, PCV and ferritin levels were found at fourth and eighth weeks in IV group when compared to oral group.Conclusions: This study concluded that intravenous iron sucrose is safe and highly efficacious for the treatment of anemia in pregnancy. It restores iron stores more promptly. Iron sucrose therapy is more effective in achieving the optimum results, an increase in hemoglobin concentration, PCV levels and an increase in ferritin levels also. Therefore, it is a suitable alternative to oral iron with minimal side effects in those patients who cannot tolerate oral iron therapy.
ABSTRACT
Objective: To compare the efficacy and safety of different oral and parenteral iron preparations in patients with anemia. Methods: An observational, prospective study in patients of anemia in pregnancy and chronic kidney disease (CKD) receiving iron sucrose, oral ferrous ascorbate and ferrous sulfate were included. Demographic details, clinical history, baseline hemoglobin, anemia indices data were recorded in a case record form. The patients were followed up monthly for 12 weeks and observed for clinical and haematological improvement and adverse drug reactions (ADRs). The data was analyzed using paired t-test, unpaired t-test and Fisher`s exact test. Results: Out of 232 patients, 84 received iron sucrose, 62 ferrous ascorbate and 86 ferrous sulfate. Oral and parenteral iron preparations significantly (P<0.0001) improved mean hemoglobin, anemia indices and serum ferritin at the end of study. However, mean increase in hemoglobin and anemia indices were significant (P<0.0001) with iron sucrose (4.42 ± 0.17gms/dL) as compared to ferrous ascorbate (3.45 ± 0.1) and sulfate (3.3 ± 0.4). Increase in serum ferritin was more and rapid (at 4 weeks) with iron sucrose as compared to ferrous ascorbate in CKD patients. Surprisingly, ADRs were more in patients treated with oral ferrous sulfate (86%) and ascorbate (71%) compared to iron sucrose (63%). Conclusion: Parenteral iron sucrose improves hemoglobin. anemia indices and replenish iron stores rapidly and is well tolerated than oral iron preparations.
ABSTRACT
Aim: To compare the efficacy and safety of ferrous ascorbate and colloidal iron in children with iron deficiency anemia. Study Design: An open, randomized, comparative, parallel-group study. Place and Duration of Study: Department of Pediatric Medicine of ‘Nilratan Sircar Medical College and Hospital’, Kolkata, India, between January 2009 and February 2010. Methodology: Children between the age group of 6 months to 12 years were included if they had anemia defined as hemoglobin <10 gm%. Children received treatment with either ferrous ascorbate or colloidal iron for 12 weeks. Each child received elemental iron 3 mg/kg body weight/day. Follow-up assessments were performed at the end of week 4, week 8 and week 12. Results: Out of the 137 children screened, 80 were included in the analysis. The mean rise in hemoglobin at the end of the 12 weeks was significantly higher in ferrous ascorbate group than colloidal iron group [3.24 ± 1.66 gm% vs. 1.42 ± 2.04 gm%; p <0.01]. Responder rate (hemoglobin ≥11.5 gm%) after 12 weeks of therapy was 53.57% in ferrous ascorbate group versus 10.34% in colloidal iron group; p<0.01. Conclusion: The study provides evidence for the role of ferrous ascorbate as an efficient oral iron supplement in the treatment of iron deficiency anemia in children.
ABSTRACT
Aim: This study was aimed to assess efficacy, safety and tolerability of combination of ferrous ascorbate and folic acid (Phosfomin-XT) in patients with iron deficiency anemia (IDA). Settings and design: A total of 56 patients, who were between 18-55 years of age, with hemoglobin (Hb) 6-9 g/dl and serum ferritin <15 mg/l also complying with the inclusion and exclusion criteria in the protocol were enrolled in the study after obtaining necessary approvals and informed consent. All were dispensed with Phosfomin-XT fixed-dose combination (FDC) of ferrous ascorbate (equivalent to elemental iron 100 mg) + folic acid 1.5 mg tablet once-daily after food for eight weeks. Patients were assessed at baseline and Weeks 2, 4, 6 and 8 for change in Hb level, clinical evaluation and target Hb achievement. Results: Baseline mean Hb was 08.39 ± 0.75 g/dl, which significantly increased to 9.76 ± 0.70 g/dl (16.3%) at Week 2 and further increased to 10.70 ± 0.70 g/dl (27.53%) at Week 4. At Week 6, it increased to 11.55 ± 0.67 g/dl (37.7%) and at Week 8, it increased to 12.53 ± 1.09 g/dl. Conclusions: The present study concludes that Phosfomin-XT (ferrous ascorbate, equivalent to elemental iron 100 mg + folic acid 1.5 mg) tablet should be preferred as first choice of oral iron salts to treat IDA due to positive effect on Hb value and superior tolerability.