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Effects of Different Doses of Oral Iron on Hepcidin and Treatment Response in Iron Deficiency Anemia.

Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion
April 1, 2025
Ozlem Beyler et al. (4 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to determine how different iron supplementation regimens (every other day, once daily, twice daily) affect hepcidin levels and hematological outcomes in women with iron deficiency anemia.

Results Summary

Twice-daily iron supplementation showed the most significant improvements in hemoglobin, MCV, and ferritin levels by the 15th day and third month, respectively, but with increased gastrointestinal side effects. No significant differences in hepcidin levels were observed across groups at three months.

Population

87 female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml.

Effective Dosage

Every other day, once daily, or twice daily iron therapy (specific iron compound and dosage not specified).

Duration

90 days

Interactions

None mentioned

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
iron therapy every other day
no change
hepcidin levels
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
no significant differences
no significant differences were observed
#1
iron therapy once daily
no change
hepcidin levels
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
no significant differences
no significant differences were observed
#2
iron therapy twice daily
no change
hepcidin levels
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
no significant differences
no significant differences were observed
#3
iron therapy once daily
no change
reticulocyte counts
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
no significant difference
no significant difference was found
#4
iron therapy twice daily
no change
reticulocyte counts
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
no significant difference
no significant difference was found
#5
iron therapy twice daily
increase
hemoglobin levels
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
showed significant improvement
#6
iron therapy twice daily
increase
MCV levels
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
showed significant improvement
#7
iron therapy twice daily
increase
ferritin levels
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
were significantly higher
#8
iron therapy twice daily
increase
hematological improvements
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
results in the most significant hematological improvements
#9
iron therapy twice daily
increase
gastrointestinal side effects
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
with increased gastrointestinal side effects
#10
iron therapy every other day
decrease
side effects
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
associated with fewer side effects and better tolerability
#11
iron therapy every other day
increase
tolerability
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
associated with fewer side effects and better tolerability
#12
iron therapy every other day
decrease
support for erythropoiesis
female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml
-
may not provide adequate support for erythropoiesis
#13
Abstract

UNLABELLED: Iron deficiency anemia (IDA) is a common health problem. The hepcidin hormone is the main regulator of systemic iron balance. The body responds to IDA by decreasing hepcidin. This study investigated how different iron supplementation regimens affect hepcidin levels in women with IDA. 87 female participants aged 18-45 years with hemoglobin < 10 g/dL and serum ferritin < 20 ng/ml were assigned to receive iron therapy every other day, once daily, or twice daily. Hemogram, serum iron, serum iron binding capacity, ferritin, hepcidin, and C-reactive protein values were measured at baseline and on the 15th and 90th days of treatment in all groups. On the seventh day, no significant difference was found between the once-daily and twice-daily groups (p = 0.42) in reticulocyte counts. By the 15th day, hemoglobin and MCV levels showed significant improvement in the twice-daily group compared to the other groups (p < 0.01). At the third month, ferritin levels were significantly higher in the twice-daily group compared to the every-other-day and once-daily groups (p = 0.03). No significant differences were observed in hepcidin levels at three months across all groups. The study concludes that twice-daily iron supplementation results in the most significant hematological improvements but with increased gastrointestinal side effects. These findings underscore the importance of tailoring iron dosing schedules to individual patient needs. In cases where rapid haemoglobin response is required, twice-daily dosing may provide superior results. Conversely, once-daily dosing may be preferred if tolerable anemia can be maintained. Every other day dosing, although associated with fewer side effects and better tolerability, may not provide adequate support for erythropoiesis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12288-024-01844-5.

Study Links
Quality Scores
Safety70
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations1
Citations/Year1.0
Research Impact Scores
APT Score0.05
Weight Score8.94
Normalized Score0.78
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