Iron Infusion Study in Low-Income Settings

In a new study, researchers have found that iron infusion is highly effective in iron deficiency anemia following childbirth in low-income settings compared to oral iron tablets.

The study has been published by Swiss TPH and the Ifakara Health Institute in The Lancet Global Health.

"This is the first study to provide evidence of the benefits and safety of iron infusion compared with oral iron tablets for the treatment of iron-deficiency anaemia following childbirth in a resource-limited setting," said Sandrine Meyer-Monard, independent haematologist and senior author of the study. "We have demonstrated that iron infusions can be safely used in a rural African setting - just as it is in high-income settings."

In sub-Saharan Africa, anaemia is a major public health concern with roughly 60% of the population suffering from anaemia. Around half of those cases are due to iron deficiency. Anaemia has a negative impact on an individual's quality of life, and the economic development of a country. Women are at particularly high risk, and their risk increases during pregnancy, childbirth, and postpartum.

The currently recommended therapy for iron-deficiency anaemia in low-resource settings is daily oral iron tablets. These tablets are affordable but they require strict compliance over a long period of time, and may cause side effects. Iron infusion, while more expensive than oral iron tablets, requires just one or two doses, and treatment can be delivered at time points coinciding with routine medical visits.

In this phase III clinical trial, postpartum women in Bagamoyo and Dar es Salaam received either an iron infusion or oral iron tablets to treat their iron-deficiency anaemia. The study found that 80% of the women who received an iron infusion had normalised levels of haemoglobin after just six weeks, compared to 51% of women who were given the oral iron tablets. Importantly, the women who received the iron infusion continued to have better haemoglobin and ferritin levels after one year, indicating that the iron storage in their bodies had been regenerated.

"This is an important finding, particularly for women who have subsequent pregnancies but do not seek medical care between births," said Claudia Daubenberger, Head of the Clinical Immunology unit at Swiss TPH. "Providing an iron infusion during their time at the hospital is a powerful strategy to deliver a straightforward, effective and longer-lasting iron supplementation before discharge."

"The results of this study show the possibilities of iron infusion with ferric carboxymaltose in helping to reduce iron-deficiency anaemia where there is the greatest burden, and pave the way for approval of this drug in such settings," said Fiona Vanobberghen, first author of the publication and Senior Scientific Collaborator at the Department of Medicine, Swiss TPH.

For further reference log on to:

• Vanobberghen, F., et al. (2020) Efficacy and safety of intravenous ferric carboxymaltose compared with oral iron for the treatment of iron deficiency anaemia in women after childbirth in Tanzania: a parallel-group, open-label, randomised controlled phase 3 trial. Lancet Global Health. doi.org/10.1016/S2214-109X(20)30448-4.