Oral iron formulae for treatment of iron deficiency anemia: a comparative study

Author(s)

Alyaa S. A. Abdul-Raheem^1*, Amal Kamal², Basma Abdelmoez Ali³; ¹Department of Clinical Pharmacy, Faculty of Pharmacy, Daraya University, Minia, Egypt; ²Department of Pharmaceutics, Faculty of Pharmacy, Minia University, Minia, Egypt; ³Pediatric Department, Faculty of Medicine, Minia University, Minia, Egypt

Abstract

Iron deficiency anemia is a profound and widespread problem that faces growth and development in children. World guidelines suggest oral iron supply as the main solution for such a problem. However, gastric side effects are considered a profound obstacle against patient compliance and therapeutic recovery. Therefore, this study aimed to evaluate the effects of different iron salts and preparations on anemia status and blood indices of children with iron deficiency anemia. One hundred twenty-seven children with iron deficiency anemia aged 6 months to 10 years were examined after establishing an oral iron formula to evaluate changes in hemoglobin, red blood cells count, serum ferritin and mean corpuscular hemoglobin. Iron polymaltose drops, ferric ammonium citrate syrup, iron polymaltose syrup, bovine lactoferrin and ferrous sulphate were the selected formulae for the study. Results revealed a significant percent increase in all parameters over three months of treatment for the five groups. Lactoferrin group showed the highest final readings of all parameters after 3 months of treatment Hb 11.9±0.6 with percent increase (PI) 13.1%, RBCs 4.8±0.5, PI 19.5%, SFt 72.4, PI 244.1%, and MCV 76.7±1.5, PI 11.1%. This study introduced lactoferrin as the best oral iron formula for the treatment of iron deficiency anemia in children maintaining the maximum outcomes on blood indices and the least side effects which guarantee the best therapeutic efficacy.

Keywords

iron deficiency anemia; lactoferrin; iron polymaltose; ferrous sulphate; ferric ammonium citrate

Cite this paper

Abdul-Raheem, A. S. A., Kamal, A., Ali, B. A. (2022), Oral iron formulae for treatment of iron deficiency anemia: a comparative study, IRESPUB Journal of Life Sciences. Volume 2, Issue 1, Jan-Feb 2022, Page 8-24

References

[1] Blann, A. and N. Ahmed, Blood science: principles and pathology. 2014: John Wiley & Sons.

[2] Deb, S., Emplementation of national iron plus initiative for child health: Challanges ahead. Indian Journal of Public Health, 2015. 59(1): p. 1-2.

[3] Sachan, B., M. Idris, and A. Singh, Effect of socio-demographic characteristics on the prevalence of anemia among school going adolescent girls in Lucknow district, India. South East Asia Journal of Public Health, 2012. 2(1): p. 8-12.

[4] Allali, S., et al., Anemia in children: prevalence, causes, diagnostic work-up, and long-term consequences. Expert Review of Hematology, 2017. 10(11): p. 1023-1028.

[5] Stoltzfus, R.J. and M.L. Dreyfuss, Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. Vol. 2. 1998: Ilsi Press Washington, DC.

[6] Organization, W.H., Iron deficiency anemia. assessment, prevention, and control. A guide for programme managers, 2001: p. 47-62.

[7] Organization, W.H., Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. 2011, World Health Organization.

[8] Beard, J., Report of a Joint World Health Organization/Centers for Disease Control and, Prevention Technical Consultation on the Assessment of Iron Status at the Population Level. World Health Organization/Centers for Disease Control, 2004.

[9] Lynch, S., Indicators of the iron status of populations: red blood cell parameters. Assessing the Iron Status of populations. Second edition. Geneva, Swit‐zerland: WHO, 2004.

[10] Prasanth, R., Prevalence of anemia in both developing and developed countries around the world. World J Anemia, 2017. 1(2): p. 40-43.

[11] El-Hawy, M.A., S.A. Abd Al-Salam, and W.A. Bahbah, Comparing oral iron bisglycinate chelate, lactoferrin, lactoferrin with iron and iron polymaltose complex in the treatment of children with iron deficiency anemia. Clin Nutr ESPEN, 2021. 46: p. 367-371.

[12] Omar, O.M., et al., Lactoferrin versus iron hydroxide polymaltose complex for the treatment of iron deficiency anemia in children with cerebral palsy: a randomized controlled trial. European Journal of Pediatrics, 2021. 180(8): p. 2609-2618.

[13] Mohd Rosli, R.R., M.N. Norhayati, and S.B. Ismail, Effectiveness of iron polymaltose complex in treatment and prevention of iron deficiency anemia in children: a systematic review and meta-analysis. PeerJ, 2021. 9: p. e10527.

[14] El-Khawaga, A. and H. Abdelmaksoud, Effect of Lactoferrin Supplementation on Iron Deficiency Anemia in Primary School Children. International Journal of Medical Arts, 2019. 1(1): p. 48-52.

[15] El-Asheer, O.M., et al., Lactoferrin Efficacy versus Ferrous Sulfate in Treatment of Children with Iron Deficiency Anemia. Journal of Child Science, 2021. 11(01): p. e199-e204.

[16] Rezk, M., et al., Lactoferrin versus ferrous sulphate for the treatment of iron deficiency anemia during pregnancy: a randomized clinical trial. The Journal of Maternal-Fetal & Neonatal Medicine, 2016. 29(9): p. 1387-1390.

[17] Low, M.S.Y., et al., Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database of Systematic Reviews, 2016(4).

[18] Basrowi, R.W. and C. Dilantika, Optimizing iron adequacy and absorption to prevent iron deficiency anemia: The role of combination of fortified iron and vitamin C. World Nutrition Journal, 2021. 5(1-1): p. 33-39.

[19] He, H., et al., Dual action of vitamin C in iron supplement therapeutics for iron deficiency anemia: prevention of liver damage induced by iron overload. Food & function, 2018. 9(10): p. 5390-5401.

[20] Powers, J.M. and G.R. Buchanan, Diagnosis and Management of Iron Deficiency Anemia. Hematology/Oncology Clinics, 2014. 28(4): p. 729-745.

[21] Patil, P., et al., Comparison of therapeutic efficacy of ferrous ascorbate and iron polymaltose complex in iron deficiency anemia in children: A randomized controlled trial. The Indian Journal of Pediatrics, 2019. 86(12): p. 1112-1117.

[22] Russo, G., et al., Monitoring oral iron therapy in children with iron deficiency anemia: an observational, prospective, multicenter study of AIEOP patients (Associazione Italiana Emato-Oncologia Pediatrica). Annals of Hematology, 2020. 99(3): p. 413-420.

[23] Kumar, A. and A.K. Garai, A clinical study on Pandu Roga, iron deficiency anemia, with Trikatrayadi Lauha suspension in children. Journal of Ayurveda and integrative medicine, 2012. 3(4): p. 215-222.

[24] MUGRAGE, E.R. and M.I. ANDRESEN, VALUES FOR RED BLOOD CELLS OF AVERAGE INFANTS AND CHILDREN. American Journal of Diseases of Children, 1936. 51(4): p. 775-791.

[25] WASHBURN, A.H., BLOOD CELLS IN HEALTHY YOUNG INFANTS: IV. POSTNATAL READJUSTMENTS OF THE RED BLOOD CELLS IN INDIVIDUAL BABIES. American Journal of Diseases of Children, 1941. 62(3): p. 530-547.

[26] Bratteby, L.-E., et al., STUDIES ON ERYTHRO-KINETICS IN INFANCY:XIII. The mean Life Span and the Life Span Frequency Function of Red Blood Cells Formed during Foetal Life. Acta Paediatrica, 1968. 57(4): p. 311-320.