Efficacy and safety of intravenously administered iron sucrose with and without adjuvant recombinant human erythropoietin for the treatment of resistant iron-deficiency anemia during pregnancy.
OBJECTIVE
This study was undertaken to determine the efficacy and safety of intravenously administered iron sucrose with versus without adjuvant recombinant human erythropoietin in the treatment of gestational iron-deficiency anemia resistant to therapy with orally administered iron alone.


METHODS
Forty patients with gestational iron-deficiency anemia were randomly assigned to receive intravenously iron sucrose plus recombinant human erythropoietin or iron sucrose alone twice weekly. Target hemoglobin value was 11.0 g/dL. Efficacy measures were reticulocyte count, increase in hematocrit, and time to target hemoglobin level (treatment duration in weeks and need for continued therapy after 4 weeks).


RESULTS
Both regimens were effective, but with adjuvant recombinant human erythropoietin the reticulocyte counts were higher from day 4 (P<.01), increases in hematocrit were greater from day 11 (P <.01), and the median duration of therapy was shorter (18 vs 25 days), with more patients reaching the target hemoglobin level by 4 weeks of treatment (n = 19 vs. n = 15). The groups did not differ with respect to maternal-fetal safety parameters.


CONCLUSIONS
Adjuvant recombinant human erythropoietin safely enhanced the efficacy of iron sucrose in the treatment of gestational iron-deficiency anemia resistant to orally administered iron alone.
Breymann
C
C
Department of Obstetrics and Gynecology, the Clinic of Obstetrics, and the Division of Perinatal Physiology, University of Zurich, Switzerland.
Visca
E
E
Huch
R
R
Huch
A
A
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004906:Erythrocyte Count; D004909:Erythrocyte Indices; D004921:Erythropoietin / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000627:therapeutic use; D000077605:Ferric Oxide, Saccharated; D005293:Ferritins / Q000097:blood; D005317:Fetal Growth Retardation / Q000150:complications / Q000000981:diagnostic imaging; D005937:Glucaric Acid; D006400:Hematocrit; D006801:Humans; D010927:Placental Insufficiency / Q000150:complications / Q000000981:diagnostic imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011994:Recombinant Proteins; D017701:Reticulocyte Count; D014168:Transferrin / Q000032:analysis; D016896:Treatment Outcome; D014463:Ultrasonography
D005290:Ferric Compounds; D011994:Recombinant Proteins; D014168:Transferrin; D004921:Erythropoietin; D005293:Ferritins; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid