Researchers discovered that a treatment called ferric carboxymaltose, administered through an intravenous drip, is quicker and more effective than conventional iron tablets for addressing anaemia, and it is just as safe as the oral tablets. These findings were detailed in the journal Lancet Global Health.
Researchers discovered that a treatment called ferric carboxymaltose, administered through an intravenous drip, is quicker and more effective than conventional iron tablets for addressing anaemia, and it is just as safe as the oral tablets. These findings were detailed in the journal Lancet Global Health.
Anaemia, characterized by low blood levels, significantly impacts the health of mothers and their babies, particularly in sub-Saharan Africa and South-East Asia, where over 40% of pregnant women are affected. In Nigeria, many pregnant women remain anaemic even after taking iron tablets during pregnancy. This can be due to side effects such as diarrhea, nausea, or vomiting, or simply forgetting to take their medication. The iron treatments currently available for intravenous use in Nigeria, such as iron dextran, carry a high risk of severe side effects, while iron sucrose requires multiple doses. Therefore, an effective and safer alternative is urgently needed.
A team of researchers conducted a recent clinical trial named the IVON TRIAL, which examined ferric carboxymaltose—a new treatment for anaemia in Nigeria and much of sub-Saharan Africa.
The researchers evaluated how effective and safe this new treatment was compared to ferrous sulphate, a widely used oral iron tablet in Nigeria for treating anaemia. Their findings indicated that the intravenous ferric carboxymaltose works more swiftly and effectively in treating anaemia than the oral tablets, while also being comparably safe.
The study included 1,056 pregnant women aged 15 to 49 who were between five and seven-and-a-half months pregnant and had anaemia, defined as having a haemoglobin level below 10 g/dl.
“We utilized a web-based platform for assigning the treatment groups. One half of the participants received a single intravenous dose of iron, while the other half took oral iron tablets three times daily until delivery,” said Ochuwa A. Babah, a doctoral student at the Department of Global Public Health at Karolinska Institutet and one of the study’s authors.
Throughout the trial, the researchers monitored the participants’ haemoglobin and iron levels, and assessed them for depression at various stages. They continued to follow the mothers and their babies for six weeks post-delivery to gather additional information. Blood samples were drawn from the newborn’s umbilical cord at the time of delivery to evaluate the effect of the medication on the baby’s phosphate levels.
After four weeks, a single dose of ferric carboxymaltose delivered via intravenous drip resulted in a more rapid increase in blood levels compared to three daily doses of oral iron tablets. Additionally, the drip iron was more effective in correcting low body iron levels than the tablets. The side effects associated with the drip treatment were similar to those experienced with oral tablets, and there were no negative effects on the infants.
“These results are encouraging, as pregnant women are often hesitant to try new medications due to concerns for their babies’ safety. Our findings suggest that using this intravenous iron treatment (ferric carboxymaltose) in areas where many pregnant women suffer from anaemia, like parts of Africa, could significantly reduce the number of affected women and associated complications,” said Ochuwa A. Babah. He added:
“The pregnant women showed a willingness to accept the intravenous iron treatment during pregnancy, backed by their families’ support. Healthcare providers were prepared to administer the drip iron but noted a need for more staff and potentially a subsidy for the medication. The clinical trial has proven that the intravenous iron is effective and safe, and we are in discussions with the Federal Ministry of Health in Nigeria to include it on the essential drug list.”
This research was a joint effort between the University of Lagos, Nigeria, and Karolinska Institutet, Sweden. Other institutions involved included Bayero University, Kano State, Nigeria; Institute of Tropical Medicine, Antwerp, Belgium; Nottingham University, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; University of Minnesota Medical School, Minneapolis, USA; and Harvard T.H. Chan School of Public Health, Boston, USA. The study received funding from the Bill & Melinda Gates Foundation.
