COMPARISON OF THE EFFECTS OF TREATMENT WITH ORAL IRON EVERY DAY VERSUS EVERY OTHER DAY IN FEMALE PATIENTS WITH IRON DEFICIENCY ANEMIA

Zainab Omar*, Firas Hussein and Faisal Redwan

ABSTRACT

Background: Iron deficiency anemia(IDA) is a public health problem that affects all age groups, and it is a common cause of morbidity. Treatment is based on oral iron supplements, and daily therapy is associated with increased hepcidin that affects iron absorption with increased gastrointestinal side effects. Aim: The purpose of this study was to determine the effectiveness of daily versus alternate day supplementation of oral iron in women with IDA. Materials and Methods: This was a randomized controlled trial involved 160 women with a diagnosis of IDA at Hematology unit, Internal Medicine Department, Tishreen University Hospital, Lattakia, during one-year period 2022-2023. Patients were divided into four groups according to the method of therapy: group 1 received treatment with 600 mg ferrous gluconate as a single daily dose in the morning (40 patients), group 2 received treatment with 600 mg ferrous gluconate every other day in the morning (40 patients), group 3 received treatment with a 600 mg ferrous gluconate as equally divided dose daily (40 patients), and group 4 received treatment with 600 mg ferrous gluconate as divided equally dose every other day (40 patients). Results: Ages of the study population range from 18 to 39 years, with a mean age of 26.01±5.6. Moderate anemia represented the most frequent type (56.3%), with a significant statistical improvement in laboratory measurements in all therapeutic groups at the end of follow-up period. At the fourth week of therapy, a significant increasing in the following variables was observed frequently in the group 3 and 1 respectively; hemoglobin (3.59, 2.88 with p:0.01), mean corpuscular volume MCV (12.02,7.9 with p:0.001), hematocrit (10.18, 14 with p:0.3), and red blood cell RBC (0.71,0.38 with p:0.05). At 12 weeks, a significant increasing in ferritin observed frequently in the group 3 and 1 respectively (10.22,6.04 with p:0.001). There was a significant decreasing in red cell distribution width RDW which observed more frequently in group 3(5.98) and group 1(4.63), p:0.1. Return to normal HGB was observed in all patients(100%) in group 3 and in 37 cases(92.5%) in group 1 at 8th week of treatment. Gastrointestinal side effects developed on overage 27.5%, 10%, 12.5% and 7.5% in group 1,2,3, and 4 respectively. Conclusion: Oral iron supplements in daily split doses led to faster hematologic response with low frequency of gastrointestinal effects.

Keywords: Alternate day therapy, anemia, iron deficiency, ferrous gluconate, gastrointestinal side effects.