Intravenous Iron Sucrose versus Oral Iron Supplementation... : Official journal of the American College of Gastroenterology | ACG (original) (raw)

ORIGINAL CONTRIBUTION: INFLAMATORY BOWEL DISEASE

Intravenous Iron Sucrose versus Oral Iron Supplementation for the Treatment of Iron Deficiency Anemia in Patients with Inflammatory Bowel Disease—A Randomized, Controlled, Open-Label, Multicenter Study

Schröder, Oliver M.D.1; Mickisch, Oliver M.D.2; Seidler, Ursula M.D.3; de Weerth, Andreas M.D.4; Dignass, Axel U. M.D.5; Herfarth, Hans M.D.6; Reinshagen, Max M.D.7; Schreiber, Stefan M.D.8; Junge, Ulrich M.D.9; Schrott, Marc PharmD.1; Stein, Jürgen M.D., Ph.D.1

1First Department of Internal Medicine, Division of Gastroenterology, ZAFES, Johann Wolfgang Goethe-University, Frankfurt, Germany

2Private Gastroenterology Practice, Mannheim, Germany

3Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany

4Department of Medicine, University Hospital Eppendorf, Hamburg, Germany

5Charité Medical School-Virchow Clinic, Department of Medicine, Division of Hepatology and Gastroenterology, Berlin, Germany

6Department of Internal Medicine I, University of Regensburg, Regensburg, Germany

7Department of Medicine I, University of Ulm, Ulm, Germany

8First Department of Medicine, Christian-Albrechts-University, Kiel, Germany

9Municipal Hospitals Bielefeld, Hospital Rosenhöhe, Bielefeld, Germany

Reprint requests and correspondence: Oliver Schröder, M.D., First Department of Internal Medicine, ZAFES, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt Main, Germany.

Received February 15, 2005; accepted June 7, 2005.

Abstract

OBJECTIVES

Anemia is a frequent complication in patients with inflammatory bowel disease (IBD). The optimal route for iron supplementation to replenish iron stores has not been determined so far. We therefore evaluated the efficacy and safety of intravenous iron sucrose as compared with oral iron sulfate for the treatment of iron deficiency anemia (IDA) in patients with IBD.

METHODS

A randomized, prospective, open-label, multicenter study was performed in 46 patients with anemia and transferrin saturation ≤20% and/or serum ferritin concentrations ≤20 μg/L. The intravenous group received a single dose of iron sucrose of 7 mg iron/kg body weight, followed by five 200 mg infusions for the following 5 wks. The oral group received iron sulfate 100–200 mg per day for 6 wks.

RESULTS

While a comparable increase in hemoglobin was observed for both administration routes (median increase 0.25 g/L in the intravenous group vs 0.21 g/L in the oral group), only iron sucrose led to a rise in serum ferritin concentrations. Intractable gastrointestinal adverse events caused permanent study drug discontinuation in five patients (20.8%) receiving iron sulfate, whereas only one patient (4.5%) had to be withdrawn because of side effects due to iron sucrose.

CONCLUSIONS

Although being equal in short-term efficacy and overall tolerability our results suggest a better gastrointestinal tolerability for iron sucrose. Larger trials are mandatory to prove a possible advantage of iron sucrose in short- and long-term efficacy as well as in tolerability over iron sulfate in the management of IDA in IBD.