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Intravenous Iron Therapy Associated with Fewer Transfusions, But More Infections — Physician’s First Watch

Medical News |
August 19, 2013

Intravenous Iron Therapy Associated with Fewer Transfusions, But More Infections

By Joe Elia

Intravenous iron therapy seems to reduce the need for blood transfusion, but at the cost of increasing the likelihood of infection, according to a BMJ meta-analysis.

Researchers evaluated outcomes from over 70 trials involving almost 11,000 participants. The trials compared intravenous versus with oral or no iron (or both).

Overall, hemoglobin concentrations increased by 0.65 g/dL compared with oral or no iron. The need for transfusion was reduced by roughly 25%, but after excluding studies with high risk for bias, that association was no longer significant. The risk for infection was increased by about 30% with intravenous iron.

The authors conclude that controlled trials are needed "to define whether [intravenous iron therapy] should be used as a first line treatment."

Reader Comments (2)

Ramon Simon-Lopez Physician, Hematology

There are evidences that patients with Ferritin > 100 ng/mL have increased number of infections Teehan GS. Clin Infect Dis
2004;38:1090-4.. We have demonstrated that patients under rHuEpo that receive excess of i.v. Iron have iron overload (Ghoti H et al.Eur J Haematol 2012 Mar 21 together with other authors Am J Med, Vol 125, No 10, October 2012. We think that keepping levels of Ferritin between 150 and 200 ng/mL is more than enough to keep an Iron efficcient erythropoieis, even under rHuEpo treatment. More than that will bring side effects as infections, cancer, etc. "Iron is necessary, too much Iron is bad"

Silvia Rudoy MD Physician, Hematology, Buenos Aires city

The conclusions are ridiculous . Intravenous iron therapy is the best instead of red-cell transfusions

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