Retrospective evaluation of the effects of intravenous iron carboximaltose and iron sucrosis therapies on hemoglobin increase in patients with diagnosis of iron deficiency anemia

Introduction: Anemia is defined as decrease in erythrocyte amount or hemoglobin concentration. Anemia, according to the World Health Organization (WHO), is described as hemoglobin (Hb) value <13 g / dl in men over 15 years of age, <12 g / dl in women over 15 years of age and non-pregnant women, and <11 g / dl in pregnant women. Iron deficiency anemia is anemia that occurs when daily iron lost from the body cannot be compensated with the iron taken into the body. More than 30% of the world's population has anemia due to any reason, and the frequency of iron deficiency without anemia is even higher. Therefore, prevention and treatment of iron deficiency is an important public health problem, especially in women. The aim of the treatment is to apply individualized treatment for the patient and the underlying cause, and to normalize hemoglobin levels and iron stores of the patient. Parenteral iron preparations are available for those who cannot tolerate oral iron treatment or do not respond to oral iron. In our study, we aim to compare the effect of iron sucrose and iron carboxymaltose, which are parenteral iron preperations, on the increase in hemoglobin level. Material and Method: In this study, which was carried out with the permission of the Ethics Committee of Duzce University with decision number 2019/148 and in accordance with the principles of Helsinki Declaration, patients admitted to internal medicine/hematology outpatient clinics or internal medicine ward of Duzce University between March 2016 and March 2019, evaluated as iron deficiency anemia and treated with ıntravenous iron were retrospectively scanned. 140 patients were included in the study and they were divided into two groups as those who received intravenous iron sucrose or intravenous iron carboxymaltose. In both groups; age, gender, hemoglobin, hematocrit, platelet count, iron, transferrin saturation, ferritin and side effect profile were compared in four different time periods as before treatment, at 1st, 3rd, and 6th months. Results: Groups are homogeneous in terms of age and gender. There was no significant difference between the groups in terms of Hb, Hct, MCV, platelet, ferritin and TS median values measured at the time of admission. Hb, Hct, ferritin levels and amount of Hb increase measured in 1. month was found higher in iron carboxymaltose group than iron sucrose group. While Hb, MCV and ferritin levels measured in 3rd month was found to be higher in iron carboxymaltosis than iron sucrose group, MCV and ferritin levels measured at 6 months were higher in iron carboxymaltosis group than iron sucrose group. On the other hand, TS was found to be higher in iron sucrose group than iron carboxymaltosis group in all time periods. The proportion of individuals with side effects in the iron sucrose group was higher than that of the iron carboxymaltosis group. Conclusion: When the parameters measured in the beginning, 1st, 3rd, and 6th months in two groups receiving intravenous iron therapy were compared, it was found that hemoglobin increase rate was higher and the response time to treatment was shorter in iron carboxymaltosis group. It was found that treatment response was obtained in 6 months in both groups, and the final values were in the normal range. Although the side effect rate is higher in iron sucrose group, these side effects are not life threatening and both treatments are considered safe and effective. Keywords: Iron deficiency anemia, iron carboxymaltose, iron sucrose, intravenous iron