A Prospective, Randomized, Interventional Study of Oral Iron Supplementation Comparing Daily Dose with Alternate Day Regimen Using Hepcidin as a Biomarker in Iron Deficiency Anemia.
Study Goal
To compare the effectiveness and gastrointestinal side effects of daily versus alternate-day oral iron therapy in treating iron deficiency anemia (IDA), using hepcidin as a biomarker.
Results Summary
Alternate-day iron therapy resulted in a significantly greater increase in hemoglobin and reticulocyte hemoglobin equivalent (RET-He) compared to daily therapy, with fewer gastrointestinal side effects. Hepcidin levels rose more sharply in the daily therapy group, suggesting better iron absorption with alternate-day dosing.
Population
Patients with iron deficiency anemia (20 in each group).
Effective Dosage
60mg of elemental iron (ferrous sulfate), either daily or on alternate days.
Duration
21 days.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
alternate day oral iron therapy | no change | Hepcidin | patients of IDA | not significant | rise in Hepcidin was not significant from base line | #1 |
daily oral iron therapy | increase | Hepcidin | patients of IDA | significant | significantly increased | #2 |
alternate day oral iron therapy | increase | hepcidin | patients of IDA | significant | rise in hepcidin was significant from base line | #3 |
daily oral iron therapy | increase | hepcidin | patients of IDA | significant | rise in hepcidin was significant from base line | #4 |
alternate day oral iron therapy | increase | RET-He | patients of IDA | - | RET-He began increasing | #5 |
daily oral iron therapy | increase | RET-He | patients of IDA | - | RET-He began increasing | #6 |
alternate day oral iron therapy | increase | RET-He | patients of IDA | significant | rise in RET-He was significant from base line | #7 |
daily oral iron therapy | no change | RET-He | patients of IDA | not significant | rise in RET-He was not significant | #8 |
alternate day oral iron therapy | increase | hemoglobin | patients of IDA | 1.58 ±0.53 gm/dl | mean increase in hemoglobin was significantly more | #9 |
daily oral iron therapy | increase | hemoglobin | patients of IDA | 0.41 ± 0.25 gm/dl | mean increase in hemoglobin | #10 |
Alternate day single tablet dosing schedule of oral iron therapy (60mg of elemental iron, ferrous sulfate) | neutral | - | patients of IDA | - | was more effective | #11 |
Alternate day single tablet dosing schedule of oral iron therapy (60mg of elemental iron, ferrous sulfate) | decrease | gastrointestinal side effects | patients of IDA | - | better tolerated | #12 |
AIM: To assess effect of daily vis-a-vis alternate day oral iron therapy in terms of hemoglobin, reticulocyte hemoglobin equivalent (RET-He) and GI side effects using hepcidin as a biomarker. METHODS: A hospital based randomized interventional two-arm analytical study was done among patients of IDA (20 in each group). The study population was divided into two groups by randomisation. Group 1 received oral iron supplements on alternate day and Group 2 received iron supplements daily. Hemoglobin, RET-He, Serum ferritin and Hepcidin level were assessed. RESULTS: On day 2nd, the rise in Hepcidin was not significant from base line in alternate day therapy group but was significantly increased in daily therapy group. On day 3, the rise in hepcidin was significant from base line in both the groups but the mean change in hepcidin was more in daily therapy group. RET-He began increasing on day 2nd in both the groups. In alternate day therapy group, the rise in RET-He was significant from base line from the day 2nd onwards while the rise in RET-He in daily therapy group was not significant even on day 3. In alternate day iron therapy group, the mean increase in hemoglobin on day 21th (1.58 ±0.53 gm/dl) was significantly more than mean increase among daily therapy (0.41 ± 0.25 gm/dl, P <0.05). CONCLUSION: Alternate day single tablet dosing schedule of oral iron therapy (60mg of elemental iron, ferrous sulfate) was more effective and better tolerated (gastrointestinal side effects) compared to daily supplementation in IDA.