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This prospective, randomized controlled trial sought to rigorously scrutinize the efficiency and safety of high-dose intravenous iron compared to oral iron in the treatment of iron deficiency anemia, with a focus on both rapid hematologic improvement and patient well-being.
For iron deficiency anemia management, high-dose intravenous iron leads to faster and more significant improvements in hemoglobin levels, iron metabolism, and fatigue scores when compared to oral iron.
This prospective, randomized controlled trial sought to rigorously scrutinize the efficiency and safety of high-dose intravenous iron compared to oral iron in the treatment of iron deficiency anemia, with a focus on both rapid hematologic improvement and patient well-being.
In total, 338 iron deficiency anemia patients were enrolled. Of these patients, 169 were administered high-dose intravenous iron, and 169 received oral iron therapy for about 12 weeks. Primary outcomes centered on changes in hemoglobin from baseline to week 4. Secondary outcomes assessed improvements in hemoglobin levels, iron metabolism markers (serum iron, transferrin saturation, total iron binding capacity, serum ferritin), fatigue scores, treatment efficacy, and the incidence of adverse effects in both groups.
Both treatment approaches led to improvements in hemoglobin levels; however, the intravenous group exhibited a notably faster and more pronounced increase. This rapid response highlighted the superior efficacy of intravenous iron, with a substantially greater rise in hemoglobin when compared to the oral treatment after just 4 weeks. The incidence of adverse events was comparable between the two groups, as shown in Table 1:
Furthermore, iron metabolism parameters—including serum iron, transferrin saturation, total iron binding capacity, and serum ferritin—demonstrated noticeably greater improvements in the intravenous group at 4 weeks. Fatigue scores also improved more markedly in the intravenous group, reflecting a quicker recovery in quality of life.
High-dose intravenous iron offered a rapid and robust improvement in hemoglobin, iron metabolism, and fatigue in patients with iron deficiency anemia. This treatment not only accelerated hematologic recovery but also enhanced patient well-being, all while maintaining a favorable safety profile.
Zhonghua Xue Ye Xue Za Zhi (Chinese Journal of Hematology)
[Comparison of the efficacy and safety between high-dose intravenous iron and oral iron in treating iron deficiency anemia: a multicenter, prospective, open-label, randomized controlled study]
Q Zhang et al.
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