#284 Iron dosing frequency: Is less more or just less?
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- 40 females with ferritin ≤25µg/L, daily x14 days or alternating days x28 days.1
- Hemoglobin started ~130g/L: both groups increased 4g/L.
- Ferritin increased: 15µg/L versus 10µg/L (alternating day dosing), not quite statistically different (p=0.06).
- 24 females with ferritin ≤15µg/L, daily or twice/week x90 days.2
- Hemoglobin started ~124g/L: increased 6g/L versus 8g/L (twice/week dosing), not statistically different.
- Ferritin increased: 16µg/L versus 4µg/L (twice/week dosing), statistically different.
- 203 anemic females, daily or twice/week x12 weeks.3
- Hemoglobin started ~91g/L: increased ~32g/L versus ~29g/L (twice/week dosing), statistically different.4
- Abdominal pain (41% versus 5%), nausea (11% versus 1%), and vomiting (6% versus 0%) increased with daily dosing (statistically different, by authors).
- 223 anemic females, daily x3 months or twice/week x1 year.5
- Hemoglobin started ~97g/L: increased ~23g/L versus ~31g/L (twice/week dosing), statistics not reported.
- Ferritin: both groups increased ~20 µg/L.
- Total adverse events higher in once daily (39%) versus twice/week dosing (18%). Nausea, vomiting, and constipation most common.
- All dropouts: 12% versus 4% (twice/weekly), not quite statistically different (p=0.053).
- 204 females (49% anemic), daily or twice/week x3 months.6
- Hemoglobin increased 7.4g/L versus 8.5g/L (twice/week), not statistically different.4
- Ferritin improved more with daily iron (numbers not provided).
- Overall limitations include lack of blinding,1-3,5,6 imbalanced follow-up duration between study groups,1,5 poor randomization,1,5 and short follow-up.1
- Trials demonstrate a trade-off with intermittent iron (every second day or twice/week): leading to slightly lower improvement in hemoglobin (≤3 g/L) and ferritin (12 µg/L) but less adverse events that may promote adherence.