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Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial
Doaa El Amrousy1, Dalia El-Afify2, Abdallah Elsawy3
1Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt. doaa.moha@med.tanta.edu.eg.
Insights
Lactoferrin effectively treats iron-deficiency anemia (IDA) in children with inflammatory bowel disease (IBD), showing better results and fewer side effects than traditional oral iron supplements.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Nutritional Science
Background:
- Iron-deficiency anemia (IDA) is prevalent in pediatric inflammatory bowel disease (IBD) patients.
- Oral iron supplements often cause gastrointestinal distress, leading to poor patient compliance.
- Alternative treatments for IDA in IBD are needed.
Purpose of the Study:
- To compare the efficacy and tolerability of lactoferrin versus oral ferrous sulfate for treating IDA in children with IBD.
- To evaluate the impact of these treatments on key hematological and inflammatory markers.
Main Methods:
- A randomized controlled study involving 80 children with IBD and IDA.
- Participants received either ferrous sulfate (6 mg/kg/day) or lactoferrin (100 mg/day) for 3 months.
- Comprehensive blood tests were conducted before and after treatment.
Main Results:
- Both treatments significantly improved hemoglobin, serum iron, transferrin saturation, and ferritin levels.
- Lactoferrin demonstrated superior efficacy in increasing hemoglobin, serum iron, transferrin saturation, and ferritin compared to ferrous sulfate.
- Lactoferrin also led to significant reductions in IL-6 and hepcidin levels.
Conclusions:
- Lactoferrin presents a promising and effective alternative for managing IDA in pediatric IBD patients.
- Lactoferrin offers a better side effect profile compared to oral elemental iron.
- Further research into lactoferrin's role in IBD management is warranted.
Background:
Iron-deficiency anemia (IDA) is common in children with inflammatory bowel disease (IBD); however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. We compared the effect of lactoferrin versus oral ferrous sulfate for the treatment of IDA in children with IBD.
Methods:
Ninety-two IBD children with IDA were included but only 80 children completed the study and they were randomized into two groups: ferrous sulfate group (n = 40) who received ferrous sulfate 6 mg/kg/day for 3 months and lactoferrin group (n = 40) who received lactoferrin 100 mg/day for 3 months. Complete blood count, serum iron, total iron-binding capacity (TIBC), transferrin saturation (TS), serum ferritin, interleukin-6 (IL-6), and hepcidin 25 were measured before and after the treatment.
Results:
Hemoglobin (Hb), mean corpuscular volume, serum iron, TS, and serum ferritin significantly increased, while TIBC decreased significantly after the administration of either ferrous sulfate or lactoferrin compared to their baseline data. In addition, lactoferrin significantly increased Hb, serum iron, TS, and serum ferritin compared to ferrous sulfate. Moreover, lactoferrin significantly decreased IL-6 and hepcidin levels.
Conclusion:
Lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.
Clinical Trial Registration:
The study was registered at www.pactr.org (PACTR202002763901803).
Impact:
Iron-deficiency anemia (IDA) in children with inflammatory bowel disease (IBD) is treated with oral iron therapy; however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. To the best of our knowledge, our study was the first in pediatrics that compared the effect of lactoferrin versus oral ferrous sulfate as an iron supplement for the treatment of IDA in children with IBD. We found that lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.
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