Efficacy and Tolerability of Intravenous Ferric Carboxymaltose versus Oral Ferrous Sulfate for the Treatment of Severe Iron Deficiency Anemia in Postpartum Women

International Journal of Medicine and Medical Sciences | Vol. 14, No. 12, December 2024 | pp. 89–96

DOI: 10.46882/2024/IJMMS/140089

Original Research Article

Efficacy and Tolerability of Intravenous Ferric Carboxymaltose versus Oral Ferrous Sulfate for the Treatment of Severe Iron Deficiency Anemia in Postpartum Women

Fatima Z. Bello¹, Kwaku A. Mensah², Grace N. Ojo¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract:

Postpartum iron deficiency anemia compromises maternal quality of life and impairs neonatal bonding, requiring rapid iron replenishment strategies. This randomized, open-label, comparative clinical trial evaluated the therapeutic efficacy, safety, and tolerability of a single dose of intravenous ferric carboxymaltose (FCM) versus standard oral ferrous sulfate in postpartum women. We evaluated 140 postpartum women presenting within 48 hours of delivery with severe iron deficiency anemia (hemoglobin [Hb] between 6.0 and 8.0 g/dL and serum ferritin < 15 ng/mL). Participants were randomly assigned to receive either a single intravenous infusion of FCM (1000 mg, n = 70) or oral ferrous sulfate (200 mg three times daily for 6 weeks, n = 70). The primary endpoint was the mean increase in Hb levels at week 3 and week 6 post-intervention. Data analysis revealed that the mean increase in Hb at week 3 was significantly higher in the intravenous FCM arm (+2.85 ± 0.42 g/dL) compared to the oral iron arm (+1.42 ± 0.31 g/dL, p < 0.001). By week 6, target Hb normalization (≥ 11.0 g/dL) was achieved by 91.4% of the FCM group versus 68.6% of the oral ferrous sulfate group (p < 0.01). Serum ferritin replenishment was significantly higher in the FCM cohort (p < 0.001). Adverse events were generally mild; however, severe gastrointestinal side effects were significantly more frequent in the oral iron arm (28.6%) than the FCM arm (4.3%, p < 0.001). Intravenous ferric carboxymaltose achieves faster hemoglobin recovery and superior iron store replenishment with better gastrointestinal tolerability than oral ferrous sulfate in postpartum women.

Keywords: Postpartum Anemia, Iron Deficiency, Ferric Carboxymaltose, Ferrous Sulfate, Hemoglobin Recovery, Ferritin

Manuscript Timeline: Received: September 10, 2024; Revised: October 18, 2024; Accepted: November 12, 2024; Published: December 16, 2024.

Citation: Bello FZ, Mensah KA, Ojo GN. Efficacy and Tolerability of Intravenous Ferric Carboxymaltose versus Oral Ferrous Sulfate for the Treatment of Severe Iron Deficiency Anemia in Postpartum Women. International Journal of Medicine and Medical Sciences, 2024, 14(12): 89–96. DOI: 10.46882/2024/IJMMS/140089

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