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Indian Pediatrics Sep 2023Various therapeutic iron preparations are available in the market, which differ in their pharmacokinetic and safety profiles. There is insufficient evidence regarding... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Various therapeutic iron preparations are available in the market, which differ in their pharmacokinetic and safety profiles. There is insufficient evidence regarding the superior safety or efficacy of one over the other.
OBJECTIVES
To study the effects of iron preparations on various parameters like hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and serum ferritin.
STUDY DESIGN
A systematic review and meta-analysis of randomized controlled trials (RCT) was conducted from inception till 3 June, 2022.
DATA SOURCES AND SELECTION CRITERIA
Databases like MEDLINE and COCHRANE were searched for RCTs evaluating the effects and safety profile of various iron salts in the management of iron deficiency anemia in children and adolescents.
MAIN RESULTS
Eight studies with a total of 495 children were included the review. Pooled analysis showed ferrous sulphate to cause a significant increase in hemoglobin compared with other iron compounds [mean difference (95% CI) 0.53 (0.22 to 0.83; P <0.001]. Also ferrous sulphate is superior to iron polymaltose complex (IPC) (P<0.001). However, there was a significant increase in gastrointestinal adverse effects with ferrous sulphate compared to IPC (P=0.03). Other iron compounds were more efficacious than IPC in raising hemoglobin levels (P<0.001). Among the few studies evaluating iron indices like MCV, MCH, and serum ferritin, there was no significant difference between the iron preparations (P>0.05).
CONCLUSION
A low quality evidence suggests that ferrous sulphate is more efficacious than other compounds (P<0.001); though, there is an increase in gastrointestinal side effects with ferrous sulphate.
Topics: Adolescent; Child; Infant; Humans; Anemia, Iron-Deficiency; Iron; Iron Compounds; Hemoglobins; Ferritins
PubMed: 37209050
DOI: No ID Found -
Nutrition Reviews Jul 2023Iron deficiency and anemia have serious consequences, especially for children and pregnant women. Iron salts are commonly provided as oral supplements to prevent and... (Meta-Analysis)
Meta-Analysis
The effects of oral ferrous bisglycinate supplementation on hemoglobin and ferritin concentrations in adults and children: a systematic review and meta-analysis of randomized controlled trials.
CONTEXT
Iron deficiency and anemia have serious consequences, especially for children and pregnant women. Iron salts are commonly provided as oral supplements to prevent and treat iron deficiency, despite poor bioavailability and frequently reported adverse side effects. Ferrous bisglycinate is a novel amino acid iron chelate that is thought to be more bioavailable and associated with fewer gastrointestinal (GI) adverse events as compared with iron salts.
OBJECTIVE
A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the effects of ferrous bisglycinate supplementation compared with other iron supplements on hemoglobin and ferritin concentrations and GI adverse events.
DATA SOURCES
A systematic search of electronic databases and grey literature was performed up to July 17, 2020, yielding 17 RCTs that reported hemoglobin or ferritin concentrations following at least 4 weeks' supplementation of ferrous bisglycinate compared with other iron supplements in any dose or frequency.
DATA EXTRACTION
Random-effects meta-analyses were conducted among trials of pregnant women (n = 9) and children (n = 4); pooled estimates were expressed as standardized mean differences (SMDs). Incidence rate ratios (IRRs) were estimated for GI adverse events, using Poisson generalized linear mixed-effects models. The remaining trials in other populations (n = 4; men and nonpregnant women) were qualitatively evaluated.
DATA ANALYSIS
Compared with other iron supplements, supplementation with ferrous bisglycinate for 4-20 weeks resulted in higher hemoglobin concentrations in pregnant women (SMD, 0.54 g/dL; 95% confidence interval [CI], 0.15-0.94; P < 0.01) and fewer reported GI adverse events (IRR, 0.36; 95%CI, 0.17-0.76; P < 0.01). We observed a non-significant trend for higher ferritin concentrations in pregnant women supplemented with ferrous bisglycinate. No significant differences in hemoglobin or ferritin concentrations were detected among children.
CONCLUSION
Ferrous bisglycinate shows some benefit over other iron supplements in increasing hemoglobin concentration and reducing GI adverse events among pregnant women. More trials are needed to assess the efficacy of ferrous bisglycinate against other iron supplements in other populations.
PROSPERO REGISTRATION NO
CRD42020196984.
Topics: Adult; Child; Female; Humans; Male; Pregnancy; Anemia, Iron-Deficiency; Dietary Supplements; Ferritins; Hemoglobins; Iron; Iron Deficiencies; Randomized Controlled Trials as Topic; Salts; Ferrous Compounds
PubMed: 36728680
DOI: 10.1093/nutrit/nuac106