Advertisement

Comparison of Therapeutic Efficacy of Ferrous Ascorbate and Iron Polymaltose Complex in Iron Deficiency Anemia in Children: A Randomized Controlled Trial

  • Prashant Patil
  • Prajit GeevargheseEmail author
  • Prabha Khaire
  • Trupti Joshi
  • Amol Suryawanshi
  • Smita Mundada
  • Shilpa Pawar
  • Aziz Farookh
Original Article
  • 21 Downloads

Abstract

Objective

To compare the therapeutic efficacy of Ferrous ascorbate (FA) and Iron polymaltose complex (IPC) in Iron deficiency anemia (IDA) in children.

Methods

A randomized controlled trial (RCT) was conducted at a tertiary care hospital with 125 (1–12 y) children having clinical symptoms and signs of IDA. Participants were randomized into FA group and IPC group. Both the groups received iron salts (FA or IPC) randomly in a dose of 6 mg/kg elemental iron for 3 mo and followed up on day 3, day 7, at the end of 1 mo and 3 mo for Hemoglobin (Hb), Mean corpuscular volume (MCV), Red cell distribution width (RDW) and reticulocyte count.

Results

Both groups had an improvement in hematological parameters at 3 mo of intervention. The difference in the rise of Hb (g%) at the end of 1 mo in FA group (3.13 ± 1.01) vs. IPC group (2.0 ± 0.85); p = 0.017 and at 3 mo in FA group (4.88 ± 1.28) vs. IPC group (3.33 ± 1.33); p = 0.001 was statistically significant. The difference in the rise of mean Hb was significantly better in FA than the IPC group F [3392] =1.79; p = 0.00 (ANOVA). The difference in the mean increase in MCV (fL) at day 7 in FA group (6.71 ± 8.32) vs. IPC group (2.91 ± 6.16); p = 0.011 and at 1 mo FA group (9.80 ± 8.56) vs. IPC group (5.35 ± 6.11); p = 0.004 was statistically significant. The mean decrease in RDW (%) at 1 mo in FA group (4.23 ± 3.27) vs. IPC group (2.67 ± 1.95); p = 0.005 and at 3 mo in FA group (5.74 ± 3.63) vs. IPC group (4.04 ± 2.17); p = 0.006 was statistically significant. The difference in the rise in mean reticulocyte count at day 3 in FA group (0.88 ± 0.50) vs. IPC group (0.43 ± 1.20); p = 0.017 and at day 7 in FA group (4.00 ± 1.69) vs. IPC group (2.19 ± 1.24); p = 0.001 was statistically significant. F [2294] = 29.2, p = 0.00 (ANOVA). During the study period, the FA group had minor adverse reactions whereas the IPC group had none.

Conclusions

Both the iron salts (FA and IPC) used in the treatment of IDA showed statistically significant improvement in the hematological parameters during the 3 mo of intervention. The improvement in hematological parameters was better in FA supplemented patients as compared to IPC.

Keywords

Iron deficiency anemia Ferrous ascorbate Iron polymaltose complex Comparison of ferrous ascorbate and iron polymaltose complex 

Notes

Authors’ Contribution

PP and PG: Conceptualized and designed the study, designed data collection instruments, collected data, carried out initial analyses, drafted the initial manuscript, and approved the final manuscript as submitted. PK, TJ, AS, SM, SP and AF carried out the further analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. PP is the guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

References

  1. 1.
    Lanzkowsky P. Iron deficiency anemia. In: Lanzkowsky P, Lipton JM, Fish JD, editors. Lanzkowsky Manual of Pediatric Hematology and Oncology, 6th ed. London: Elsevier; 2016. p. 32–41.Google Scholar
  2. 2.
    Verma N, Naseem S. Hypochromic anemia: iron deficiency anemia and sideroblastic anemia. In: Saxena R, editor. Gruchy’s Clinical Haemotology in Medical Practice, 6th adapted ed. New Delhi: Wiley; 2014. p. 33–57.Google Scholar
  3. 3.
    Sills R. Iron deficiency anemia. In: Behrman RE, editor. Nelson Textbook of Paediatrics, Vol. II, First South Asia Edition (Reprint 20th ed). New Delhi: Elsevier; 2016. p. 2323–6.Google Scholar
  4. 4.
    Niranjan S. Nutritional anemias in infancy and childhood. In: Parthasarathy A, editor. IAP Textbook of Pediatrics, 6th ed. New Delhi: Jaypee Brother’s Medical Publishers; 2016. p. 749–834.Google Scholar
  5. 5.
    Geisser P, Müller A. Iron pharmacokinetics after administration of ferric-hydroxide polymaltose complex in rats. Arzneimittelforschung. 1984;34:1560–9.Google Scholar
  6. 6.
    Svoboda M, Ficek R, Drábek J. Evaluation of the efficacy of iron polymaltose complex in the prevention of anaemia in piglets. Bull Vet Inst Pulawy. 2008;52:119–23.Google Scholar
  7. 7.
    Jaiswar DR, Amin PD. Solid-state characterization of ferrous ascorbate. Int J Pharm Pharm Sci. 2012;4:282–7.Google Scholar
  8. 8.
    Goddard AF, James MW, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. Gut. 2011;60:1309–16.CrossRefGoogle Scholar
  9. 9.
    Bopche AV, Dwivedi R, Mishra R, Patel GS. Ferrous sulphate versus iron polymaltose complex for treatment of iron deficiency anemia in children. Indian Pediatr. 2009;46:883–5.Google Scholar
  10. 10.
    Devaki PB, Chandra RK, Geisser P. Effect of oral supplementation with iron (III)-hydroxide polymaltose complex on the immunological profile of adolescents with varying iron status. Arzneimittel-Forschung. 2007;57:417–25.Google Scholar
  11. 11.
    Marwat IU, Hassan KA, Javed T, Chishti AL. Comparison of the efficacy of ferrous and iron polymaltose salts in the treatment of childhood iron deficiency anemia. Annals Kemu. 2013;19:322–6.Google Scholar
  12. 12.
    Yasa B, Agaoglu L, Unuvar E. Efficacy, tolerability, and acceptability of iron hydroxide polymaltose complex versus ferrous sulfate: a randomized trial in pediatric patients with iron deficiency anemia. Int J Pediatr. 2011;2011:1–6 Article ID: 524520.CrossRefGoogle Scholar
  13. 13.
    Afzal M, Qureshi SM, Lutafullah M, Iqbal M, Sultan M, Khan SA. Comparative study of efficacy, tolerability and compliance of oral iron preparations (iron edetate, iron polymaltose complex) and intramuscular iron sorbitol in iron deficiency anaemia in children. J Pak Med Assoc. 2009;59:764–8.Google Scholar
  14. 14.
    Vetter W, Steurer J. Single-centre, open, randomised, parallel-group study comparing the efficacy and tolerability of oral ferric polymaltose complex in doses of 200 mg, 400 mg and 600 mg per day. Clinical Report [internal report]. St. Gallen, Switzerland: Vifor (International) Inc; 2000.Google Scholar
  15. 15.
    Ganguly S, Dewan B, Philipose N, Samanta T, Paul DK, Purkait R. Comparison between ferrous ascorbate and colloidal iron in the treatment of iron deficiency anemia in children from Kolkata, India. Br J Med Med Res. 2012;2:195–205.CrossRefGoogle Scholar
  16. 16.
    Guinea JM. Results of preoperative autotransfusion with ferrous ascorbate prophylaxis in orthopedic surgery patients. Sangre (Barc). 1996;41:25–8.Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Department of PediatricsGMCH AurangabadAurangabadIndia

Personalised recommendations