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Oral Iron-Hydroxide Polymaltose Complex Versus Sucrosomial Iron for Children with Iron Deficiency with or without
Sonia Alexiadou1, Christina Tsigalou2, Eleni Kourkouni3
1Department of Pediatrics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Thrace, Greece.
Insights
Oral iron therapy effectively treats iron deficiency anemia (IDA) and iron deficiency without anemia (IDWA) in children. This study found no evidence that recommended doses of iron (III)-hydroxide polymaltose complex or sucrosomial iron cause intestinal inflammation.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Nutritional Science
Background:
- Iron deficiency anemia (IDA) and iron deficiency without anemia (IDWA) are prevalent childhood health issues.
- Concerns exist that oral iron supplements may induce gut inflammation.
- Understanding the gastrointestinal effects of oral iron is crucial for pediatric health.
Purpose of the Study:
- To investigate the potential of oral iron therapy to cause intestinal inflammation in children with IDA or IDWA.
- To compare the effects of two different oral iron formulations on gut inflammation markers.
Main Methods:
- A randomized study involving 56 children (6 months-16 years) with IDA or IDWA.
- Participants received either iron (III)-hydroxide polymaltose complex (IPC) or sucrosomial iron (SI) for 90 days.
- Fecal calprotectin levels were measured to assess intestinal inflammation.
Main Results:
- Both IPC and SI significantly increased serum ferritin levels, indicating effective iron repletion.
- No significant changes in fecal calprotectin were observed in either treatment group.
- No differences in inflammatory markers or hematological parameters were noted between the two iron formulations.
Conclusions:
- Oral iron therapy with IPC and SI is effective for treating IDA and IDWA in children.
- Current evidence suggests that oral iron at recommended doses does not induce intestinal inflammation.
- These findings support the safety of common oral iron treatments for pediatric iron deficiency.
Background:
Iron deficiency anemia (IDA) is a major public health problem among children worldwide. Iron deficiency without anemia (IDWA) is at least twice as common as IDA. Some studies propose that oral iron fortification can modify the infant's gut microbiome, leading to intestinal inflammation.
Objectives:
To determine whether oral iron therapy can lead to intestinal inflammation in children with IDA or IDWA.
Patients And Methods:
Fifty-six patients aged 6 months to 16 years (median age 7.6 years) with IDA or IDWA were randomly assigned to receive either iron (III)-hydroxide polymaltose complex (IPC) 5 mg/kg once daily (maximum dose 100 mg) or sucrosomial iron (SI)1.4 mg/kg once daily (maximum dose 29.4 mg). Safety and efficacy were studied after 30 and 90 days of treatment. In addition, fecal calprotectin as a marker of intestinal inflammation was measured simultaneously and compared to results obtained before therapy.
Results:
A significant increase in serum ferritin was noted in both groups as the median ferritin level at baseline was 6.7 μg/L in the IPC group and 6.6 μg/L in the SI group, increasing to 15.9 μg/L and 12.1 μg/L respectively, after 90 days of treatment. However, there was no significant change in fecal calprotectin in either group. In addition, no differences in the trend over time were observed between the two groups regarding fecal calprotectin, serum ferritin, and hemoglobin.
Conclusions:
IPC and SI were equally effective in treating IDA and IDWA. At the recommended doses, oral iron therapy does not seem to induce intestinal inflammation.
