Comparative study of efficacy of oral iron versus parenteral iron in the treatment of iron deficiency anaemia

Abstract

Background: Iron deficiency anaemia (IDA) is one of the most widespread nutritional deficiency and common medical conditions seen in everyday clinical practice. IDA has a substantial haematological complication with potentially serious clinical consequences that often may require iron therapy. In most patients, body stores of iron can be restored by oral iron therapy but parenteral iron therapy results rapid correction of haemoglobin levels, faster and higher replenishment of iron stores with better compliance. The study was to compare the efficacy of oral iron (ferrous sulphate) with parenteral iron (iron sucrose) to treat iron deficiency anaemia. Methods: 221 patients were included in the study. 101 patients were given oral iron in the form of ferrous sulphate containing 67 mg of elemental iron three times daily. 120 patients were treated with iron sucrose.  After a 25 mg test dose on the first infusion only, this was given at a dose of 300 mg by intravenous infusion diluted in 250 ml of normal saline, every alternate day. Haemoglobin level and serum ferritin of both groups were done before iron therapy, 3 weeks and 12 weeks after iron therapy. Results: The mean±SD rise of haemoglobin concentration 3 weeks after iron therapy in iron sucrose group was 11.2±0.60 g/dL, while in ferrous sulphate group was 9.0±0.58 g/dL. The mean±SD ferritin 3 weeks after iron therapy in iron sucrose group was 81.0±15.18 ng/mL, while in ferrous sulphate group was 27.0±12.22 ng/mL. The mean±SD haemoglobin concentration 12 weeks after iron therapy in iron sucrose group was 12.2±0.60 g/dL, while in ferrous sulphate group was 11.0±0.58 g/dL. The mean±SD ferritin 12 weeks after iron therapy in iron sucrose group was 82.0±16.17 ng/mL, while in ferrous sulphate group was 52.0±12.22 ng/mL. No serious adverse events were reported in either the ferrous sulphate group or iron sucrose group. Conclusion: Iron sucrose causes higher rise in haemoglobin level and serum ferritin as compared to oral iron therapy.